The Global Epidemiology of Mental and Substance Use Disorders

Heslin, Kevin C.

doi:10.1007/978-3-030-18435-3_2

Cited by 18 publications

(29 citation statements)

References 83 publications

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“…Surgical patients with OUD have distinct characteristics and require clinical care that is responsive to their unique needs, including pain and withdrawal management. 9 , 10 Consistent with other literature, we found that surgical patients with OUD were disproportionally insured by Medicaid 4 , 42 and younger, 4 more frequently experienced mental health comorbidities, 43 , 44 and more often had a patient-directed discharge. 45 Our finding that 1.3% of surgical patients had OUD is higher than another population-based study that found 0.6% prevalence, 5 but that study used International Classification of Diseases, Ninth Revision codes that are known to be less sensitive for identifying OUD than the ICD-10 codes that we used.…”

Section: Discussionsupporting

confidence: 89%

Nursing Resources Linked to Postsurgical Outcomes for Patients With Opioid Use Disorder

French

McHugh

Aiken

et al. 2022

Annals of Surgery Open

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Objectives: To determine whether better nursing resources (ie, nurse education, staffing, work environment) are each associated with improved postsurgical outcomes for patients with opioid use disorder (OUD). Background: Hospitalized patients with OUD are at increased risk of adverse outcomes. Evidence suggests that adverse postsurgical outcomes may be mitigated in hospitals with better nursing resources, but this has not been evaluated among surgical patients with OUD. Methods: Cross-sectional (2015–2016) data were utilized from the RN4CAST-US survey of hospital nurses, the American Hospital Association Annual Survey of hospitals, and state patient hospital discharge summaries. Multivariate logistic and zero-truncated negative binomial regression models were employed to examine the association between nursing resources and 30-day readmission, 30-day in-hospital mortality, and length of stay for surgical patients with OUD. Results: Of 919,601 surgical patients in 448 hospitals, 11,610 had identifiable OUD. Patients with compared to without OUD were younger and more often insured by Medicaid. Better nurse education, staffing, and work environment were each associated with better outcomes for all surgical patients. For patients with OUD, each 10% increase in the proportion of nurses with a bachelor’s degree in nursing was associated with even lower odds of 30-day readmission (odds ratio [OR] = 0.88; P = 0.001), and each additional patient-per-nurse was associated with even lower odds of 30-day readmission (OR = 1.09; P = 0.024). Conclusions: All surgical patients fare better when cared for in hospitals with better nursing resources. The benefits of having more nurses with a bachelor’s degree and fewer patients-per-nurse in hospitals appear greater for surgical patients with OUD.

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Section: Discussionsupporting

confidence: 89%

Nursing Resources Linked to Postsurgical Outcomes for Patients With Opioid Use Disorder

French

McHugh

Aiken

et al. 2022

Annals of Surgery Open

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“…In particular, we found that greater scores in disinhibition, negative affectivity, and psychoticism were associated with a significantly longer length of stay, while a greater score in detachment was associated with a decreased length of stay. One way to interpret the effect sizes we observed is to compare our results to the US national average length of stay in inpatient psychiatric units, which is 6.6 days (Heslin et al ., 2015). According to our results, an increase of 10% in the disinhibition dimension score may increase inpatient length of stay by 40% when compared to the national average.…”

Section: Discussionmentioning

confidence: 99%

Characterizing DSM-5 and ICD-11 personality disorder features in psychiatric inpatients at scale using electronic health records

et al. 2019

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BackgroundInvestigation of personality traits and pathology in large, generalizable clinical cohorts has been hindered by inconsistent assessment and failure to consider a range of personality disorders (PDs) simultaneously.MethodsWe applied natural language processing (NLP) of electronic health record notes to characterize a psychiatric inpatient cohort. A set of terms reflecting personality trait domains were derived, expanded, and then refined based on expert consensus. Latent Dirichlet allocation was used to score notes to estimate the extent to which any given note reflected PD topics. Regression models were used to examine the relationship of these estimates with sociodemographic features and length of stay.ResultsAmong 3623 patients with 4702 admissions, being male, non-white, having a low burden of medical comorbidity, being admitted through the emergency department, and having public insurance were independently associated with greater levels of disinhibition, detachment, and psychoticism. Being female, white, and having private insurance were independently associated with greater levels of negative affectivity. The presence of disinhibition, psychoticism, and negative affectivity were each significantly associated with a longer stay, while detachment was associated with a shorter stay.ConclusionsPersonality features can be systematically and scalably measured using NLP in the inpatient setting, and some of these features associate with length of stay. Developing treatment strategies for patients scoring high in certain personality dimensions may facilitate more efficient, targeted interventions, and may help reduce the impact of personality features on mental health service utilization.

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“…Substance use disorder (SUD) groupings were derived from Healthcare Cost and Utilization Project definitions. 13 14 Conditions included alcohol, cannabis, opioid, methamphetamine, cocaine/crack, sedatives or unspecified/other SUDs.…”

Section: Methodsmentioning

confidence: 99%

Health profiles and racial disparities among individuals on probation in Hennepin County, Minnesota, 2016: a cross-sectional study

et al. 2021

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ObjectivesTo estimate the health characteristics and racial/ethnic health disparities among a probation cohort in Hennepin County. We hypothesised the probation population would have higher health needs compared with the general population as well as significant racial/ethnic health disparities.DesignCross-sectional study using linked administrative records.ParticipantsOf 7992 eligible individuals, 5873 met inclusion criteria of 6 or more months of eligibility for a full-benefit Minnesota healthcare plan.SettingProbation system in Hennepin County in 2016.OutcomesWe compared health condition prevalence among our probation cohort with survey data from the general population and analysed by race/ethnicity. We also measured sociodemographic characteristics, including the use of safety-net services.ResultsIndividuals were predominantly male (80.5%), young (mean age: 35.5 years), and disproportionately black or African American (52.9%). A majority of individuals enrolled in Medicaid were eligible via Medicaid expansion (65.9%). Compared with the general population, individuals on probation had higher rates of substance use disorders (66.5% vs 8.1%), mental illness (55.3% vs 14.4%) and many physical conditions (eg, asthma: 17.0% vs 12.5%, chronic kidney disease: 5.8% vs 0.2%). White individuals on probation were significantly more likely than black or African American individuals to have a diagnosed substance use disorder (71.6% vs 62.0%) or mental health disorder (64.9% vs 48.5%), but fewer chronic physical health conditions (average: 0.52 vs 0.73 chronic physical conditions).ConclusionsIndividuals on probation have high health needs, which vary substantially by race/ethnicity. Without attention to this variation, interventions to address health conditions in this population could worsen racial/ethnic disparities.

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The Global Epidemiology of Mental and Substance Use Disorders

Cited by 18 publications

References 83 publications

Nursing Resources Linked to Postsurgical Outcomes for Patients With Opioid Use Disorder

Nursing Resources Linked to Postsurgical Outcomes for Patients With Opioid Use Disorder

Characterizing DSM-5 and ICD-11 personality disorder features in psychiatric inpatients at scale using electronic health records

Health profiles and racial disparities among individuals on probation in Hennepin County, Minnesota, 2016: a cross-sectional study

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