The number of hospital admissions among Americans ages 45 and older for medication and drug-related conditions doubled between 1997 and 2008, according to a new report released today by HHS' Agency for Healthcare Research and Quality. Medication and drug-related conditions include effects of both prescription and over-the-counter medications as well as illicit drugs.
Hospital admissions among those 45 years and older were driven by growth in discharges for three types of medication and drug-related conditions - drug-induced delirium; "poisoning" or overdose by codeine, meperidine and other opiate-based pain medicines; and withdrawal from narcotic or non-narcotic drugs.
Admissions for all medication and drug-related conditions grew by 117 percent - from 30,100 to 65,400 - for 45- to 64-year-olds between 1997 and 2008. The rate of admissions for people ages 65 to 84 closely followed, growing by 96 percent, and for people ages 85 and older, the rate grew by 87 percent. By comparison, the number of hospital admissions for these conditions among adults ages 18 to 44 declined slightly by 11 percent.
"This report reveals a disturbing trend, and we need to find out more about why these admissions are increasing," said AHRQ Director Carolyn M. Clancy, M.D. "As the average age of hospital patients continues to increase, so does the need for close monitoring of the types and dosages of drugs given to them."
Drug-induced delirium or dementia can be caused by sleeping pills as well as drugs for urinary incontinence, nausea and other problems common in the elderly, but doctors sometimes cannot identify the cause. Poisoning by pain medicines or other drugs containing codeine, meperidine or other opiates can be caused by accidental overdosing or the failure to recognize the drug's active ingredient. Drug withdrawal occurs when there is an abrupt withdrawal or significant reduction in the dosage of pain or other prescription medicines to which a person can become addicted, as well as of illicit drugs.
HHS' Substance Abuse and Mental Health Services Administration helped support the analysis of the data in the report on hospital care for mental health and substance abuse disorders."Substance abuse is rising, and drug abuse of all kinds is exploding as a major public health concern for our country," said SAMHSA Administrator Pamela S. Hyde, J.D. "The challenge for our health care practitioners is to see that patients receive medications when there is medical need but also to help prevent the adverse health consequences from drug use."
The new AHRQ report also shows that Medicare and Medicaid were responsible for 57 percent of the $1.1 billion cost to hospitals in 2008 for treating patients with medication and drug-related conditions, private insurance covered 24 percent, and the uninsured accounted for 14 percent. The remaining 5 percent of hospital costs for treating these conditions were borne by other sources such as TRICARE.
AHRQ's report also includes data on other types of medical conditions treated in U.S. community hospitals, surgical and other procedures, and costs in 2008.
Agency for Healthcare Research and Quality