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Whereas most studies of inpatient stay for mental illness examine whether substance use is present, this study identified types or combinations of abused substances that most increased hospitalization risk.Logistic regression of data from the 2007 National Survey of Drug Use and Health (N=37,654) was used to predict past-year hospitalization of individuals with DSM-IV substance use disorders.Even after the inclusion of control variables, adults with four types of substance abuse or dependence were more likely to be hospitalized than adults without substance abuse or dependence. High-risk disorders included abuse of or dependence on opioid analgesics (odds ratio [OR]=6.85, p.001), cocaine (OR=2.65, p.05), alcohol and cocaine (OR=2.58, p.05), and alcohol and marijuana (OR=3.10, p.01).Researchers examining inpatient stays may find it beneficial to look at abuse of specific substances or combinations of substances, and efforts to prevent inpatient stays could target people with high-risk substance use disorders.

The authors evaluated the evolution of inpatient care for psychiatric illness in 1992 and 2002 for senior community-dwelling Medicare beneficiaries.National Medicare Provider Analysis and Review files for 1992 and 2002 were analyzed.From 1992 to 2002, rates of inpatient hospital use for treatment of psychiatric illness declined 28%, from 429 to 311 stays per 100,000 eligible beneficiaries, mostly because of reduced hospitalization for depression, and next, for substance use disorder. Inpatient care patterns for patients with schizophrenia and bipolar disorder changed little. Although stays were shorter in 2002 in general, rehospitalization rates remained the same in 2002 as they were in 1992.Trends in hospitalizations differed by diagnoses, which may be representative of general changes in treatment philosophy during the 1990s.