Hospitalizations and hospital charges for co-occurring substance use and mental disorders

The Health Education and Promotion Program, Kent State University, Kent, Ohio 44242, USA.
Journal of substance abuse treatment (Impact Factor: 2.9). 02/2011; 40(4):366-75. DOI: 10.1016/j.jsat.2010.12.005
Source: PubMed


Most published studies have examined co-occurring disorders among mental health patients. Our objective was to compare the length of stay and hospital charges between hospitalized patients with alcohol- or substance-related disorders with and without co-occurring disorders. We analyzed nationally representative hospital discharge data (Nationwide Inpatient Sample, 2003-2007) and examined factors associated with length of stay and hospital charges. Forty-four percent of patients who were hospitalized with alcohol- or substance-related disorders were diagnosed with co-occurring mental disorders, representing 979,421 such disorders nationwide between 2003 and 2007. Females, those of White race, those who paid with insurance, and those who stayed in large, rural, nonteaching, and Midwest region hospitals had a high prevalence of co-occurring disorders. Co-occurring disorders were associated with longer hospital stays, but there were mixed results with hospital charges per discharge. An increase in co-occurring disorders among hospitalized patients with substance-related disorder may be due to the improvement in diagnosis and clinical attention.

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    • "These contradictory findings may be explained by important differences in the samples. Schizophrenia and other psychotic disorders comprised almost 50 percent of patients with CODs in the current study, whereas these disorders comprised only 10 percent of patients with CODs in the study reported by Ding et al. (2011). One possible explanation for shorter hospital stays among patients with CODs is that co-occurring substance abuse may temporarily exacerbate psychiatric symptoms (Blow et al. 1998; Ries et al. 2000). "
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