Expenditures in Mental Illness and Substance Use Disorders among Veteran Clinic Users with Diabetes
First Online: 30 May 2008 Received: 26 June 2007 Accepted: 21 March 2008 DOI:
Cite this article as: Banerjea, R., Sambamoorthi, U., Smelson, D. et al. J Behav Health Serv Res (2008) 35: 290. doi:10.1007/s11414-008-9120-8 Abstract
Few studies have looked at the health-care expenditures of diabetes patients based on the type of co-occurring conditions of mental illness (MI) or substance use disorders (SUD). Our study analyzes the health-care expenditures associated with various diagnostic clusters of co-occurring drug, alcohol, tobacco use, and mental illness in veterans with diabetes. We merged Veteran Health Administration and Medicare fee-for-service claims database (fiscal years 1999 and 2000) for analysis (
N = 390,253) using generalized linear models; SUD/MI were identified using International Classification of Diseases, 9th edition codes. The total average expenditures (fiscal year 2000) were lowest ($6,185) in the “No MI and No SUD” and highest ($19,801) for individuals with schizophrenia/other psychoses and alcohol/drug use. High expenditures were associated with both SUD and MI conditions in diabetes patients, and veterans with alcohol/drug use had the highest expenditures across all groups of MI. These findings reinforce the need to target groups with multiple comorbidities specifically those with serious mental illnesses and alcohol/drug use for interventions to reduce health-care expenditures. Keywords diabetes chronic illness with complexity expenditures substance use mental illness References
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