Substance abuse and hospitalization for mood disorder among Medicaid beneficiaries

Abstract

Objectives: We compared the influence of substance abuse with that of other comorbidities (e.g., anxiety, HIV) among people with mood disorder (N=129,524) to explore risk factors for psychiatric hospitalization and early readmission within 3 months of discharge.

Methods: After linking Medicaid claims data in 5 states (California, Florida, New Jersey, New York, and Texas) to community-level information, we used logistic and Cox regression to examine hospitalization risk factors.

Results: Twenty-four percent of beneficiaries with mood disorder were hospitalized. Of these, 24% were rehospitalized after discharge. Those with comorbid substance abuse accounted for 36% of all baseline hospitalizations and half of all readmissions.

Conclusions: Results highlight the need for increased and sustained funding for the treatment of comorbid substance abuse and mood disorder, and for enhanced partnership between mental health and substance abuse professionals.

FIGURE 1

Percentage of Medicaid beneficiaries with mood disorder who were not readmitted to the hospital within 90 days of discharge, by presence (n = 10 995) versus absence (n = 19 893) of substance abuse: Medicaid Analytic extract, 1999–2000. Note. There was a statistically significant difference between the 2 groups (χ²₁ = 923.57; P < .001).