Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders

Objective: We aim to examine the relationships between substance use disorders and preventable hospitalizations for Ambulatory Care Sensitive Conditions among adult Medicaid beneficiaries. Methods: Cross-sectional analysis using de-identified Medicaid claims data in 2012 from 177,568 beneficiaries i...

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Main Authors: Kit Sang Leung, Joe Parks, James Topolski
Format: Article
Language:English
Published: Elsevier 2015-01-01
Series:Preventive Medicine Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2211335515000595
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author Kit Sang Leung
Joe Parks
James Topolski
author_facet Kit Sang Leung
Joe Parks
James Topolski
author_sort Kit Sang Leung
collection DOAJ
description Objective: We aim to examine the relationships between substance use disorders and preventable hospitalizations for Ambulatory Care Sensitive Conditions among adult Medicaid beneficiaries. Methods: Cross-sectional analysis using de-identified Medicaid claims data in 2012 from 177,568 beneficiaries in Missouri was conducted. Logistic regression models were estimated for the associations of substance use disorder status with Ambulatory Care Sensitive Conditions, demographics, chronic physical and mental illnesses. Zero-inflated negative binomial regressions assessed substance use disorders, hospitalization for Ambulatory Care Sensitive Conditions, and length of hospital stay for Ambulatory Care Sensitive Conditions adjusting for co-morbid physical illnesses, mental illnesses and demographics. Results: Over 12% of the sample had been diagnosed for substance use disorder. Beneficiaries with substance use disorder were more likely than Nonsubstance use disorder beneficiaries to have admissions for chronic conditions including short/long-term complications of diabetes, uncontrolled diabetes, hypertension, chronic obstructive pulmonary disease/asthma, but not for acute conditions. While substance use disorder beneficiaries were more likely than Nonsubstance use disorder beneficiaries to be hospitalized for any Ambulatory Care Sensitive Conditions; there were no statistical differences between the two groups in terms of length of hospital stays. Conclusions: Substance use disorder is statistically associated with hospitalizations for most Ambulatory Care Sensitive Conditions but not with length of hospital stay for Ambulatory Care Sensitive Conditions, after adjusting for covariates. The significant associations between substance use disorder and Ambulatory Care Sensitive Condition admissions suggest unmet primary health care needs for substance use disorder beneficiaries and a need for integrated primary/behavioral healthcare.
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spelling doaj.art-9fe8b684e2a24d77a2fcfc571f60afd52022-12-21T20:07:31ZengElsevierPreventive Medicine Reports2211-33552015-01-012C37938410.1016/j.pmedr.2015.04.022Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disordersKit Sang Leung0Joe Parks1James Topolski2MIMH,University of Missouri — St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134-3115, USAMIMH,University of Missouri — St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134-3115, USAMIMH,University of Missouri — St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134-3115, USAObjective: We aim to examine the relationships between substance use disorders and preventable hospitalizations for Ambulatory Care Sensitive Conditions among adult Medicaid beneficiaries. Methods: Cross-sectional analysis using de-identified Medicaid claims data in 2012 from 177,568 beneficiaries in Missouri was conducted. Logistic regression models were estimated for the associations of substance use disorder status with Ambulatory Care Sensitive Conditions, demographics, chronic physical and mental illnesses. Zero-inflated negative binomial regressions assessed substance use disorders, hospitalization for Ambulatory Care Sensitive Conditions, and length of hospital stay for Ambulatory Care Sensitive Conditions adjusting for co-morbid physical illnesses, mental illnesses and demographics. Results: Over 12% of the sample had been diagnosed for substance use disorder. Beneficiaries with substance use disorder were more likely than Nonsubstance use disorder beneficiaries to have admissions for chronic conditions including short/long-term complications of diabetes, uncontrolled diabetes, hypertension, chronic obstructive pulmonary disease/asthma, but not for acute conditions. While substance use disorder beneficiaries were more likely than Nonsubstance use disorder beneficiaries to be hospitalized for any Ambulatory Care Sensitive Conditions; there were no statistical differences between the two groups in terms of length of hospital stays. Conclusions: Substance use disorder is statistically associated with hospitalizations for most Ambulatory Care Sensitive Conditions but not with length of hospital stay for Ambulatory Care Sensitive Conditions, after adjusting for covariates. The significant associations between substance use disorder and Ambulatory Care Sensitive Condition admissions suggest unmet primary health care needs for substance use disorder beneficiaries and a need for integrated primary/behavioral healthcare.http://www.sciencedirect.com/science/article/pii/S2211335515000595Preventable hospitalizationAvoidable hospitalizationAmbulatory Care Sensitive ConditionACSCSubstance use disordersSubstance abuseAddictionMedicaid
spellingShingle Kit Sang Leung
Joe Parks
James Topolski
Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders
Preventive Medicine Reports
Preventable hospitalization
Avoidable hospitalization
Ambulatory Care Sensitive Condition
ACSC
Substance use disorders
Substance abuse
Addiction
Medicaid
title Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders
title_full Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders
title_fullStr Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders
title_full_unstemmed Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders
title_short Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders
title_sort preventable hospitalizations among adult medicaid beneficiaries with concurrent substance use disorders
topic Preventable hospitalization
Avoidable hospitalization
Ambulatory Care Sensitive Condition
ACSC
Substance use disorders
Substance abuse
Addiction
Medicaid
url http://www.sciencedirect.com/science/article/pii/S2211335515000595
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