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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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.
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.PubMedCentralPubMedCrossRefGoogle 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.PubMedCrossRefGoogle 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.PubMedCrossRefGoogle 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.PubMedCrossRefGoogle Scholar
Elixhauser, A., Steiner, C., Harris, D. R., et al. (1998). Comorbidity measures for use with administrative data. Medical Care,36, 8–27.PubMedCrossRefGoogle Scholar
Hart, A., & Stegman, M. (Eds.). (2007). ICD-9-CM Expert for hospitals (6th ed., Vol. 1, 2 & 3). New York: Ingenix.Google Scholar
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.PubMedCrossRefGoogle 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.PubMedCentralPubMedCrossRefGoogle 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.PubMedCrossRefGoogle Scholar
Klinkenberg, W. D., & Calsyn, R. J. (1998). Predictors of psychiatric hospitalization: A multivariate analysis. Administration and Policy in Mental Health,25(4), 403–410.PubMedCrossRefGoogle 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.PubMedCrossRefGoogle 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.Google Scholar
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.PubMedCrossRefGoogle Scholar
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.PubMedCrossRefGoogle 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.PubMedCrossRefGoogle 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.Google Scholar
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.Google Scholar
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.Google Scholar
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.PubMedCrossRefGoogle 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.PubMedGoogle Scholar