Leo Sher, M.D.
A paper, “High inpatient utilization among Veterans Health Administration patients with substance-use disorders and co-occurring mental health conditions” has been published in the American Journal of Drug and Alcohol Abuse (1). Service utilization information and demographic and clinical data were obtained from a national sample of Veterans Health Administration patients with substance use disorder only (n = 148,960), substance use disorder plus serious mental illness (i.e., schizophrenia or bipolar disorder; n = 75,913), and substance use disorder plus other mental illness (n = 245,675). High inpatient utilization was defined as the upper 10% of the study sample in terms of total inpatient utilization distribution.
Prevalence of high inpatient utilization in the substance use disorder only group was 6.2% in comparison with 22.7% and 9.7% in the substance use disorder plus serious mental illness and substance use disorder plus other mental illness groups, respectively. Older age, unmarried, homelessness, suicide risk, pain diagnosis, alcohol/opioid/sedative-use disorders, and prior-year emergency department/inpatient utilization were predictors of high inpatient utilization in all 3 patient groups. The authors suggest that their findings indicate which services are needed for patients with substance use disorder and co-occurring mental health concerns. Such services should include acute crisis management, chronic disease management, and homeless care services.
- Painter JM, Malte CA, Rubinsky AD, Campellone TR, Gilmore AK, Baer JS, Hawkins EJ. High inpatient utilization among Veterans Health Administration patients with substance-use disorders and co-occurring mental health conditions. Am J Drug Alcohol Abuse. 2017 Nov 2:1-9. doi: 10.1080/00952990.2017.1381701. [Epub ahead of print]