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
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.
Available from: Jennifer I Manuel
- "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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ABSTRACT: This study examined trends in general hospital discharges and dispositions involving episodes of severe mental illness (SMI) with and without co-occurring substance use disorders. We analyzed data from the National Hospital Discharge Survey from 1979 through 2008. Discharges involving SMI and co-occurring substance use disorders (COD) were associated with shorter lengths of stay and had a greater likelihood of being discharged routinely or home and reduced likelihood of being transferred to a short- or long-term facility. Although COD discharges had a greater odds of leaving against medical advice than SMI discharges, this effect was not significant over time. A greater understanding of hospital discharge planning practices is needed to ensure that patients are linked to appropriate aftercare services.
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ABSTRACT: To evaluate hospitalisation data for patients with a primary or secondary fibromyalgia (FM) diagnosis. We estimated the number of men and women with an FM diagnostic code and compared them across a number of demographic and hospitalisation characteristics; examined age-specific, population-based FM hospitalisation rates; and determined the most common co-morbid diagnoses when FM was either the primary or secondary diagnostic code.
Hospital discharge data from the Nationwide Inpatient Sample (NIS) were used. Records were evaluated between 1999 and 2007 that contained the International Classification of Diseases, 9th Revision, Clinical Modification FM diagnostic code (729.1, Myositis and Myalgia, unspecified), the FM criterion used in large-scale health services studies.
There were 1,727,765 discharges with a 729.1 diagnostic code (FM) during this nine-year span, 213,034 men (12.3%) and 1,513,995 women (87.6%). Discharges coded for FM increased steadily each year. The population-based rate of male FM discharges rose gradually across the lifespan; the rate for women rose sharply but then declined after age 64. Few differences between men and women across demographic and hospitalisation characteristics were evident. The most common co-morbidities with FM as the primary diagnosis were non-specific chest pain, mood disorders, and Spondylosis/intervertebral disc disorders/other back problems. Most common primary diagnoses, with FM as a secondary diagnosis, were essential hypertension, disorders of lipid metabolism, coronary atherosclerosis/other heart disease, and mental disorders.
A substantial number of U.S. residents with FM were hospitalised over the study period. Further analysis of hospitalisation data from patients with FM may provide guidance for both research and treatment, with the goal of improved care for FM patients.
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