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Hospital Readmission Rates and Emergency Department Visits for Mental Health and Substance Abuse Conditions

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Abstract

Community hospital stays in 12 states during 2008–2009 were analyzed to determine predictors of 12-month hospital readmission and emergency department (EDs) revisits among persons with a mental health or substance abuse diagnosis. Probabilities of hospital readmission and of ED revisits were modeled as functions of patient demographics, insurance type, number of prior-year hospital stays, diagnoses and other characteristics of the initial stay, and hospital characteristics. Alcohol or drug dependence, dementias, psychotic disorders, autism, impulse control disorders, and personality disorders were most strongly associated with future inpatient admission or ED revisits within 12 months of initial encounter. Insurance type, including uninsured status, were highly significant (p < .01) predictors of both readmission and ED revisits.

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References

  • Cherpitel, C. J., & Ye, Y. (2008). Trends in alcohol- and drug-related ED and primary care visits: Data from three US national surveys (1995–2005). The American Journal of Drug and Alcohol Abuse, 34, 576–583.

    Article  PubMed Central  PubMed  Google Scholar 

  • Coleman, E. A., Parry, C., Chalmers, S., et al. (2006). The care transitions intervention: Results of a randomized controlled trial. Archives of Internal Medicine, 166, 1822–1828.

    Article  PubMed  Google Scholar 

  • Crane, S., Collins, L., Hall, J., et al. (2012). Reducing utilization by uninsured frequent users of the emergency department: Combining case management and drop-in group medical appointments. Journal of the American Board of Family Medicine, 25(2), 184–191.

    Article  PubMed  Google Scholar 

  • Doupe, M. B., Palatnick, W., Day, S., et al. (2012). Frequent users of emergency departments: Developing standard definitions and defining prominent risk factors. Annals of Emergency Medicine, 60(1), 24–32.

    Article  PubMed  Google Scholar 

  • Elixhauser, A., Steiner, C., Harris, D. R., et al. (1998). Comorbidity measures for use with administrative data. Medical Care, 36, 8–27.

    Article  CAS  PubMed  Google Scholar 

  • Hart, A., & Stegman, M. (Eds.). (2007). ICD-9-CM Expert for hospitals (6th ed., Vol. 1, 2 & 3). New York: Ingenix.

    Google Scholar 

  • HCUP Central Distributor (2008). SID description of data elements—all states. healthcare cost and utilization project (HCUP). Rockville, MD: Agency for Healthcare Research and Quality. http://www.hcup-us.ahrq.gov/db/vars/siddistnote.jsp?var=visitlink. Accessed July 3, 2014.

  • Ilgen, M. A., Unger Hu, K., Moos, R. H., et al. (2008). Continuing care after inpatient psychiatric treatment for patients with psychiatric and substance use disorders. Psychiatric Services, 59(9), 982–988.

    Article  PubMed  Google Scholar 

  • Jack, B. W., Chetty, V. K., Anthony, D., et al. (2009). A re-engineered hospital discharge program to decrease re-hospitalization: A randomized trial. Annals of Internal Medicine, 150, 178–187.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jencks, S. F., Williams, M. V., & Coleman, E. A. (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine, 360, 1418–1428.

    Article  CAS  PubMed  Google Scholar 

  • Kaiser Commission on Medicaid and the Uninsured. Medicaid Health Homes for Beneficiaries with Chronic Conditions, Publication No. 8340, August 2012. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8340.pdf.

  • Klinkenberg, W. D., & Calsyn, R. J. (1998). Predictors of psychiatric hospitalization: A multivariate analysis. Administration and Policy in Mental Health, 25(4), 403–410.

    Article  CAS  PubMed  Google Scholar 

  • Larkin, G. L., Classen, C. A., Emond, J. A., et al. (2005). Trends in US emergency department visits for mental health conditions, 1992–2001. Psychiatric Services, 56(6), 671–677.

    Article  PubMed  Google Scholar 

  • Mark, T. L., & Tomic, K. (2012). Hospital readmission among Medicaid patients with a mental health and substance abuse hospitalization. Presented at the Academy Health Annual Research Meeting, June.

  • Naylor, M. D., Brooten, D. A., Campbell, R. L., et al. (2004). Transitional care of older adults hospitalized with heart failure: A randomized, controlled trial. Journal of the American Geriatrics Society, 52, 675–684.

    Article  PubMed  Google Scholar 

  • Owens, P.L., Mutter, R., & Stocks, C., (2012). Mental health and substance abuse-related emergency department visits among adults, 2007. HCUP Statistical Brief No. 92. July 2010. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb92.pdf. Accessed May 4, 2012.

  • Pines, J. M., Asplin, B. R., Kaji, A. H., et al. (2011). Frequent users of emergency department services: Gaps in knowledge and a proposed research agenda. Academic Emergency Medicine, 18, e64–e69.

    Article  PubMed  Google Scholar 

  • Raven, M. C., Carrier, E. R., Lee, J., et al. (2010). Substance use treatment barriers for patients with frequent hospital admissions. Journal of Substance Abuse Treatment, 38(1), 22–30.

    Article  PubMed  Google Scholar 

  • SAMHSA (Substance Abuse and Mental Health Services Administration). (2012a). Mental Health, United States, 2010 (DHHS Publication No. (SMA) 12-4681). Washington, DC: Government Printing Office.

  • SAMHSA (Substance Abuse and Mental Health Services Administration). (2012b). Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings (NSDUH Series H-45, HHS Publication No. SMA 12-4725). Washington, DC: Government Printing Office.

  • SAMHSA (Substance Abuse and Mental Health Services Administration). (2013). National Expenditures for Mental Health Services and Substance Abuse Treatment, 1986-2009 (HHS Publication No. 13-4740). Washington, DC: Government Printing Office.

  • Stranges, E., Levit, K., Stocks, C., & Santora, P., (2011). State variation in inpatient hospitalizations for mental health and substance abuse conditions, 2002-2008. HCUP Statistical Brief, no. 117. Retrieved from http://www.hcup-us.ahrq.gov/reports/statbriefs/sb117.pdf.

  • Tulloch, A. D., Fearon, P., & David, A. S. (2011). Length of stay of general psychiatric inpatients in the United States: Systematic review. Administration and Policy In Mental Health, 38, 155–168.

    Article  PubMed  Google Scholar 

  • UCLA, Academic Technology Services, Statistical Consulting Group. (2011). What are pseudo R-squareds? Retrieved from http://www.ats.ucla.edu/stat/mult_pkg/faq/general/Psuedo_RSquareds.htm.

  • Vashi, A. A., Fox, J. P., Carr, B. G., et al. (2013). Use of hospital-based acute care among patients recently discharged from the hospital. JAMA, 309(4), 364–371.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Wagner, T. H., Sinnott, P., & Siroka, A. M. (2011). Mental health and substance use disorder spending in the Department of Veterans Affairs, fiscal years 2000–2007. Psychiatric Services, 62(4), 389–395.

    PubMed  Google Scholar 

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Acknowledgments

Funding was provided by the Substance Abuse and Mental Health Services Administration and the Agency for Healthcare Research and Quality (Contract HHSA-290-2006-00009-C). We gratefully acknowledge programming support from Minya Sheng, Nils Nordstrand, and David Ross.

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Authors and Affiliations

  1. Truven Health Analytics, Bethesda, MD, USA

    Mark W. Smith

  2. Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, MD, USA

    Carol Stocks

  3. Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockville, MD, USA

    Patricia B. Santora

Authors
  1. Mark W. Smith
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  2. Carol Stocks
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  3. Patricia B. Santora
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Corresponding author

Correspondence to Mark W. Smith.

Additional information

The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of SAMHSA or AHRQ. No statement should be construed as an official position of SAMHSA, AHRQ, or the US Department of Health and Human Services.

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Smith, M.W., Stocks, C. & Santora, P.B. Hospital Readmission Rates and Emergency Department Visits for Mental Health and Substance Abuse Conditions. Community Ment Health J 51, 190–197 (2015). https://doi.org/10.1007/s10597-014-9784-x

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  • DOI: https://doi.org/10.1007/s10597-014-9784-x

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