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BACKGROUND: Drug abuse has been on the increase over the last few years, contributing to the healthcare cost. An understanding of the overall impact of drug abuse hospitalizations is essential in combatting the drug abuse epidemic.
OBJECTIVE: The objective of this study is to examine hospitalization outcomes of total charges, and length of stay, among other elements associated with drug abuse comorbidity patients. The study will compare drug abuse comorbidity patients with non-drug abuse admission. The focus is on patients that were discharged in the United States between 2010 and 2014. Drug abuse comorbidity increases the intricacy of hospitalized patients; it is necessary to analyze the outcomes. The Center for Medicare and Medicaid (CMS) also implemented a value-based care model which allows healthcare providers, including hospitals and physicians, to be paid based on patient hospitalization outcomes. Therefore an understanding of this outcome is necessary for payment and resource allocation.
METHOD: This study utilized the National (Nationwide) Inpatient Sample (NIS) for the years 2010 to 2014. The data source is an inpatient hospitalization dataset produced every year. The NIS is a publicly available all-payer inpatient health care dataset with national estimates of hospital inpatient stays. NIS collects data from more than 7 million hospital stays each year. It is estimated to be collecting more than 35 million hospitalizations nationally. NIS is a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ). In this retrospective study, we demonstrated the estimation of inpatient outcomes for total charges and length of stay. The SPSS statistical analysis software was used to analyze the data. Various descriptive and inferential analysis was performed on the filtered data sets above for the years 2010 to 2014. Results of the outcome analysis that had a p-value less than 0.05 were noted to be significant.
RESULTS: Drug abuse comorbidity cases within the five years were 2,258,235. Descriptive analysis showed that the prevalence of drug abuse comorbidity to be among males (58%), and they were more likely to be admitted compared to females (42%). This population, the median age at admissions, was 42 for males, and 40 for female. The average hospitalization length of stay was 4.5 days for non-drug abuse and 5.5 days for drug abuse comorbidity (P<0.001). Most drug abuse comorbidity hospitalization cases were charged to government-related insurance Medicaid (36.7%), Medicare (22.6%), and Private (18.2%), Self-pay (15.1% and other or unknown insurance (5.4%) P<0.001. Mean charges for drug abuse comorbidity (3.6% of population) was $36,735.98 while non-drug abuse cases (96.4% of study population) was $35,200.85 P< 0.001. The mean charges were highest in the Midwest $13,500.00 for non-drug abuse and $14,000.00 for those with drug abuse comorbidity on record. The lowest charges of $12,900 for drug abuse comorbidity and $13,300 for non-drug abuse were recorded in the Northeast. The most common primary condition associated with drug abuse comorbidity were mood, personality, and psychotic disorders.
CONCLUSION: The study revealed several significant factors related to the hospitalization of drug abuse comorbidity patients. Total charges are significantly higher for drug abuse comorbidity than general admissions. Drug abuse comorbidity hospitalization cases showed a longer length of stay than non-drug abuse cases. These results will aid as a reference for resources allocation, hospital utilization review, and policy changes related to drug abuse. Further research is necessary to find innovative care plans for people with drug abuse comorbidity.

ETD_10162

Ph.D.

Includes bibliographical references

doi:10.7282/t3-f5g1-2a93

ETD doctoral

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