Thursday, July 10, 2008

Substance abuse problems lengthen hospital stays and costs of medical treatments soar

OK so this isn't rocket science for us in the substance abuse field, but it is validating when studies articulate what we already know to be true from our practice experience.

According to a study in the July, 2008 issue of the Journal of Substance Abuse Treatment, a study done at Johns Hopkins on lengths of stays of hospitalized patients from 1994 - 2002, people who have concurrent alcohol and drug addictions stay a lot longer in the hospital and cost a lot more money to treat. It makes good sense to provide substance abuse treatment earlier in the course of the disease to prevent more expensive medical interventions later. HMOs have ignored this practice wisdom historically, but they may be catching on. It is this kind of evidence that makes the case for substance abuse treatment harder to ignore.

In this observational study, longitudinal trends (1994–2002) in hospital admissions with co-occurring alcohol/drug abuse and addiction (ADAA; N = 43,073) were examined to determine prevalence and hospital costs by payer group and type of drug used. Four primary drug types were reported: 49% used a combination of two or more drugs, 25% used alcohol only, 11.8% used opioids only, and 6.5% used cocaine only. Costs of admissions increased significantly for those using two or more drugs (119%, from US$12.7 to US$27.8 million), alcohol (120%, from US$9 to US$19.8 million), and opioids (482%, from US$1.7 to US$9.9 million). Medicaid/Medicare represented 70% of the overall number of admissions and also paid 70% of hospital costs. Among Medicaid/Medicare and uninsured admissions, illicit drug use was more common, whereas among private payer admissions, alcohol abuse was more common. Hospital admissions with co-occurring ADAA must be considered when estimating the scope of ADAA and its financial burden.

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