Risk of Early Rehospitalization for Non-Behavioral Health Conditions Among Adult Medicaid Beneficiaries with Severe Mental Illness or Substance Use Disorders

J Behav Health Serv Res. 2017 Jan;44(1):113-121. doi: 10.1007/s11414-016-9516-9.

Abstract

The goal was to examine risk factors and expenditures for early rehospitalization (within 30 days of discharge) for non-behavioral health conditions among Medicaid-enrolled Floridians over 8 years. There were 1,689,797 hospitalization episodes with 19% (N = 314,742) resulting in early rehospitalization. Total gross charges for early rehospitalization were over 13 billion dollars. In Cox proportional hazards regression adjusted for demographic and health covariates, drug use disorder was associated with 50% increased risk of early rehospitalization. Having major depressive disorder increased risk by 17%; psychotic disorder, bipolar disorder, and alcohol use disorder increased risk of early rehospitalization slightly by 10, 6, and 6% respectively. The effect of dementia on risk was minimal at 2%. Risk of early rehospitalization decreased by 3.5% per year over the 8 years of the study. Attention to mental health problems, especially drug use disorder, may help further reduce rates of early readmission for non-behavioral health conditions.

MeSH terms

  • Adult
  • Aged
  • Female
  • Florida
  • Hospitalization*
  • Humans
  • Male
  • Medicaid*
  • Mental Disorders*
  • Middle Aged
  • Patient Readmission*
  • Proportional Hazards Models
  • Risk Assessment
  • Severity of Illness Index
  • Substance-Related Disorders*
  • United States