Examining Real-World Implementation of Measurement-Based Care and Its Influence on Emergency Department Visit Risk among Outpatients with Mood and Anxiety Disorders

The practice of using validated rating scales to guide treatment—measurement-based care (MBC) remains underutilized in behavioral health. This study examined the association between real-world MBC implementation, ascertained by measure completion, and emergency department (ED) visits. A retrospective cohort design made use of medical insurance claims data (2015–2023) to examine adult psychiatric outpatients exposed to real-world MBC (“MBC” sample; n = 524); 482 were propensity score-matched to patients who received care as usual (“CAU” sample; n = 964). The index visit was the date of registry enrollment for the MBC sample and the first psychiatric encounter while enrolled for the CAU sample. Time-to-event and negative binomial models were used to estimate hazard ratios (HRs) and incidence rate ratios (IRRs) for ED visits. The overall sample included 1,488 patients (63