Almost one-fourth of all stays in U.S. community hospitals for patients age 18 and older – 7.6 million of nearly 32 million stays – involved depressive, bipolar, schizophrenia and other mental health disorders or substance use related disorders in 2004, according to a new report by HHS' Agency for Healthcare Research and Quality.
This study presents the first documentation of the full impact of mental health and substance abuse disorders on U.S. community hospitals. According to the report, about 1.9 million of the 7.6 million stays were for patients who were hospitalized primarily because of a mental health or substance abuse problem. In the other 5.7 million stays, patients were admitted for another condition but they also were diagnosed as having a mental health or substance abuse disorder.
Nearly two-thirds of costs were billed to the government: Medicare covered nearly half of the stays, and 18 percent were billed to Medicaid. Roughly 8 percent of the patients were uninsured. Private insurers were billed for the balance. The study also found that one of every three stays of uninsured patients was related to a mental health or substance abuse disorder.
“Community hospitals play an important role in the treatment of people with mental health and substance abuse disorders,” said AHRQ Director Carolyn M. Clancy, M.D. “This report gives health care policymakers an in-depth look at the impact of mental health and substance abuse care on the health care system.”
Substance Abuse and Mental Health Services Administration Administrator Terry Cline, Ph.D., said, “The significant number of hospital stays related to mental health and substance use disorders signals the need for an increased national effort to identify and intervene early before the conditions require a hospital stay. Too often because of social stigma or lack of understanding, individuals and health care providers don't recognize the signs or treat mental health or substance use disorders with the same urgency as other medical conditions.“
AHRQ found that most patients with mental health and substance abuse disorders were older. For example, although people age 80 and older comprised only 5 percent of the U.S. population in 2004, they accounted for nearly 21 percent of all hospital stays for these conditions – principally for dementia. There were also gender differences. The most frequent admitting diagnosis for women was mood disorders, while that for men was substance abuse.