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.

Reference

1. 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]