High inpatient utilization among Veterans Health Administration patients with substance-use disorders and co-occurring mental health conditions

ABSTRACTBackground. Substance-use disorders (SUDs) are common and costly conditions. Understanding high inpatient utilization (HIU) among patients with SUD can inform the development of treatment approaches designed to reduce healthcare expenditures and improve service quality. Objectives. To examine the prevalence, type, and predictors of HIU among patients with SUD and co-occurring mental health conditions. Methods. Service utilization and demographic and clinical variables were extracted from a national sample of Veterans Health Administration (VA) patients with SUD-only [n = 148,960 (98.3% male)], SUD plus serious mental illness ([i.e. schizophrenia- and/or bipolar-spectrum disorders; SUD/SMI; n = 75,913 (91.6% male)], and SUD plus other mental illness [SUD/MI; n = 245,675 (94.6% male)]. Regression models were used to examine HIU during a follow-up year. Results. Prevalence of HIU among the SUD-only group was 6.2% (95% confidence interval (CI): 6.1%–6.3%) compared with 22.7% (95% CI: 22.4%–23.0%) and ...