Kathryn Graham1,2,3,4, Joyce Cheng1, Sharon Bernards1, Samantha Wells1,2,3,5, Jürgen Rehm1,2,3,6,7, Paul Kurdyak1,7,8. 1. 1 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto/London, Ontario. 2. 2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. 3. 3 School of Psychology, Deakin University, Geelong, Australia. 4. 4 National Drug Research Institute, Curtin University, Perth, Australia. 5. 5 Department of Epidemiology, Western University, London, Ontario. 6. 6 Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Dresden, Germany. 7. 7 Department of Psychiatry, University of Toronto, Toronto, Ontario. 8. 8 Institute for Clinical Evaluative Sciences, Toronto, Ontario.
Abstract
OBJECTIVE: To measure service use and costs associated with health care for patients with mental health (MH) and substance use/addiction (SA) problems. METHODS: A 5-year cross-sectional study (2007-2012) of administrative health care data was conducted (average annual sample size = 123,235 adults aged >18 years who had a valid Ontario health care number and used at least 1 service during the year; 55% female). We assessed average annual use of primary care, emergency departments and hospitals, and overall health care costs for patients identified as having MH only, SA only, co-occurring MH and SA problems (MH+SA), and no MH and/or SA (MH/SA) problems. Total visits/admissions and total non-MH/SA visits (i.e., excluding MH/SA visits) were regressed separately on MH, SA, and MH+SA cases compared to non-MH/SA cases using the 2011-2012 sample ( N = 123,331), controlling for age and sex. RESULTS: Compared to non-MH/SA patients, MH/SA patients were significantly ( P < 0.001) more likely to visit primary care physicians (1.82 times as many visits for MH-only patients, 4.24 for SA, and 5.59 for MH+SA), use emergency departments (odds, 1.53 [MH], 3.79 [SA], 5.94 [MH+SA]), and be hospitalized (odds, 1.59 [MH], 4.10 [SA], 7.82 [MH+SA]). MH/SA patients were also significantly more likely than non-MH/SA patients to have non-MH/SA-related visits and accounted for 20% of the sample but over 30% of health care costs. CONCLUSIONS: MH and SA are core issues for all health care settings. MH/SA patients use more services overall and for non-MH/SA issues, with especially high use and costs for MH+SA patients.
OBJECTIVE: To measure service use and costs associated with health care for patients with mental health (MH) and substance use/addiction (SA) problems. METHODS: A 5-year cross-sectional study (2007-2012) of administrative health care data was conducted (average annual sample size = 123,235 adults aged >18 years who had a valid Ontario health care number and used at least 1 service during the year; 55% female). We assessed average annual use of primary care, emergency departments and hospitals, and overall health care costs for patients identified as having MH only, SA only, co-occurring MH and SA problems (MH+SA), and no MH and/or SA (MH/SA) problems. Total visits/admissions and total non-MH/SA visits (i.e., excluding MH/SA visits) were regressed separately on MH, SA, and MH+SA cases compared to non-MH/SA cases using the 2011-2012 sample ( N = 123,331), controlling for age and sex. RESULTS: Compared to non-MH/SApatients, MH/SApatients were significantly ( P < 0.001) more likely to visit primary care physicians (1.82 times as many visits for MH-only patients, 4.24 for SA, and 5.59 for MH+SA), use emergency departments (odds, 1.53 [MH], 3.79 [SA], 5.94 [MH+SA]), and be hospitalized (odds, 1.59 [MH], 4.10 [SA], 7.82 [MH+SA]). MH/SApatients were also significantly more likely than non-MH/SApatients to have non-MH/SA-related visits and accounted for 20% of the sample but over 30% of health care costs. CONCLUSIONS: MH and SA are core issues for all health care settings. MH/SApatients use more services overall and for non-MH/SA issues, with especially high use and costs for MH+SApatients.
Entities:
Keywords:
addiction; costs; general medical services; mental health; service use; substance use
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