Trends in Hospital Discharges and Dispositions for Episodes of Co-occurring Severe Mental Illness and Substance Use Disorders

Manuel, Jennifer I.; Gandy-Guedes, Megan E.; Rieker, David

doi:10.1007/s10488-014-0540-x

Cited by 9 publications

(8 citation statements)

References 38 publications

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“…The most common disposition outcome was being discharged home, which is consistent with extant research that documents comparable rates of being discharged home, ranging from 54% to 88%, depending on the sample population [25, 42, 43]. Confirming part of our hypothesis, we found that men were less likely to be discharged home than women.…”

Section: Discussionsupporting

confidence: 90%

Gender differences in discharge dispositions of emergency department visits involving drug misuse and abuse—2004-2011

Manuel

Lee

2017

Subst Abuse Treat Prev Policy

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BackgroundDrug use-related visits to the emergency department (ED) can undermine discharge planning and lead to recurrent use of acute services. Yet, little is known about where patients go post discharge. We explored trends in discharge dispositions of drug-involved ED visits, with a focus on gender differences.MethodsWe extracted data from the 2004–2011 Drug Abuse Warning Network, a national probability sample of drug-related visits to hospital EDs in the U.S. We computed weighted multinomial logistic regression models to estimate discharge dispositions over time and to examine associations between gender and the relative risk of discharge dispositions, controlling for patient characteristics.ResultsThe final pooled sample included approximately 1.2 million ED visits between 2004 and 2011. Men accounted for more than half (57.6%) of all ED visits involving drug misuse and abuse. Compared with women, men had a greater relative risk of being released to the police/jail, being referred to outpatient detox or other treatment, and leaving against medical advice than being discharged home. The relative risk of being referred to outpatient detox/drug treatment than discharged home increased over time for men versus women.ConclusionsGreater understanding of gender-based factors involved in substance-related ED visits and treatment needs may inform discharge planning and preventive interventions.

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Section: Discussionsupporting

confidence: 90%

Gender differences in discharge dispositions of emergency department visits involving drug misuse and abuse—2004-2011

Manuel

Lee

2017

Subst Abuse Treat Prev Policy

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“…Our results are somewhat different compared to the recent time-trend studies elsewhere. In a hospital discharge study from the United States, the co-occurring problems had distinctly increased over the 20 year period [17]. In our study, no such overall trend was observed.…”

Section: Discussioncontrasting

confidence: 71%

“…The individuals with both disorders had, for example, multiple visits to emergency departments [8] and increased rates of psychiatric hospitalisation [15,16]. In the United States, the comorbid population had shorter lengths of hospital stay, a greater likelihood of being discharged routinely, and reduced likelihood of being transferred to a short-or long-term facility, indicating an increasing trend of a 'revolving door syndrome' [17].…”

Section: Introductionmentioning

confidence: 99%

“…Whiteford et al [1] reported that the global disease burden concerning mental and substance use disorders in general increased by 37.6% between the years 1990 and 2010. In the United States, the hospital discharges among individuals with severe mental illness and co-occurring substance use almost doubled between the years 1979 and 2008 [17]. Therefore, more information about the trends is needed to plan, develop, and steer the service system, so that it can serve better individuals with co-occurring MHPs and substance use problems.…”

Section: Introductionmentioning

confidence: 99%

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Mental health problems among clients with substance use problems: a nationwide time-trend study

Kuussaari

Karjalainen

Niemelä

2019

Soc Psychiatry Psychiatr Epidemiol

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Purpose Mental health and substance use disorders are notable contributors to the global total burden of disease. On a population level, co-occurring mental health and substance use problems are estimated to account for 2-4%. In clinical samples, estimate is even higher. The aim of this study was to examine changes in recognized mental health problems (MHPs) and in the substance use profiles among clients with substance use problems in Finland. Methods Data concerning individuals with substance use entering Finnish social and health care services during 1 day were collected nationwide at three time-points in 2007, 2011, and 2015. Cross-tabulations and logistic regression were used for statistical analysis. Results Co-occurring MHPs and substance use problems were common: 56-60% of the clients with substance use problems were reported to have had MHPs between the years 2007 and 2015. The proportion of MHPs remained rather stable among them. Substance use profiles have changed: the proportion of illicit drug use among those who had MHPs has increased in health care services, social services, and substance use problem services. Conclusion Co-occurring substance use and MHPs among clients with substance use problems are common, and substance use profile is shifting from using alcohol only towards illicit drug use. This may even bring along more challenges for the treatment system and should be considered in future service planning.

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“…7 In addition, mental disorders and substance use disorders often cooccur, and co-occurrence increases the risk of homelessness, incarceration, relapses, chronic medical conditions, and hospital readmission. [8][9][10][11][12][13][14] A study of hospitalization trends in the United States showed that the percentage of hospitalizations related to severe mental illness increased from 1.28% in 1979 to 2.96% in 2008, and the percentage of hospitalizations with co-occurring mental disorders and substance use disorders increased steadily from 0.07% in 1979 to 1.13% in 2008. 8 In addition, mental disorders and substance use disorders pose special risks for the health and well-being of women of reproductive age and their families.…”

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confidence: 99%

Mental Health and Substance Use–Related Hospitalizations Among Women of Reproductive Age in Illinois and Wisconsin

et al. 2018

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Introduction: Mental health and substance use are growing public health concerns, but established surveillance methods do not measure the burden of these conditions among women of reproductive age. We developed a standardized indicator from administrative data to identify inpatient hospitalizations related to mental health or substance use (MHSU) among women of reproductive age, as well as co-occurrence of mental health and substance use conditions among those hospitalizations. Materials and Methods: We used inpatient hospital discharge data from 2012-2014 for women aged 15-44 residing in Illinois and Wisconsin. We identified MHSU-related hospitalizations through the principal International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis and first-listed ICD-9-CM external cause of injury code (E code). We classified hospitalizations as related to 1 of 3 mutually exclusive categories: a mental disorder, a substance use disorder, or an acute MHSU-related event. We defined co-occurrence as the presence of both mental health and substance use codes in any available diagnosis or E-code field. Results: Of 1 173 758 hospitalizations of women of reproductive age, 150 318 (12.8%) were related to a mental disorder, a substance use disorder, or an acute MHSU-related event, for a rate of 135.6 hospitalizations per 10 000 women. Of MHSUrelated hospitalizations, 115 163 (76.6%) were for a principal mental disorder, 22 466 (14.9%) were for a principal substance use disorder, and 12 709 (8.5%) were for an acute MHSU-related event; 42.4% had co-occurring mental health codes and substance use codes on the discharge record. Practice Implications: MHSU-related disorders and events are common causes of hospitalization for women of reproductive age, and nearly half of these hospitalizations involved co-occurring mental health and substance use diagnoses or events. This new indicator may improve public health surveillance by establishing a systematic and comprehensive method to measure the burden of MHSU-related hospitalizations among women of reproductive age.

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Trends in Hospital Discharges and Dispositions for Episodes of Co-occurring Severe Mental Illness and Substance Use Disorders

Cited by 9 publications

References 38 publications

Gender differences in discharge dispositions of emergency department visits involving drug misuse and abuse—2004-2011

Gender differences in discharge dispositions of emergency department visits involving drug misuse and abuse—2004-2011

Mental health problems among clients with substance use problems: a nationwide time-trend study

Mental Health and Substance Use–Related Hospitalizations Among Women of Reproductive Age in Illinois and Wisconsin

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