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AJPH First Look, published online ahead of print Nov 13, 2008
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January 2009, Vol 99, No. 1 | American Journal of Public Health 160-167
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.133249

RESEARCH AND PRACTICE

Substance Abuse and Hospitalization for Mood Disorder Among Medicaid Beneficiaries

Jonathan D. Prince, PhD, Ayse Akincigil, PhD, Donald R. Hoover, PhD, James T. Walkup, PhD, Scott Bilder, MS and Stephen Crystal, PhD

The authors are with the Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ.

Correspondence: Requests for reprints should be sent to Jonathan D. Prince, PhD, School of Social Work, Rutgers University, 536 George St, New Brunswick, NJ 08901 (e-mail: jdprince{at}rci.rutgers.edu).

Objectives. We compared the influence of substance abuse with that of other comorbidities (e.g., anxiety, HIV) among people with mood disorder (N = 129 524) to explore risk factors for psychiatric hospitalization and early readmission within 3 months of discharge.

Methods. After linking Medicaid claims data in 5 states (California, Florida, New Jersey, New York, and Texas) to community-level information, we used logistic and Cox regression to examine hospitalization risk factors.

Results. Twenty-four percent of beneficiaries with mood disorder were hospitalized. Of these, 24% were rehospitalized after discharge. Those with comorbid substance abuse accounted for 36% of all baseline hospitalizations and half of all readmissions.

Conclusions. Results highlight the need for increased and sustained funding for the treatment of comorbid substance abuse and mood disorder, and for enhanced partnership between mental health and substance abuse professionals.




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