Psychiatric hospital outcomes of dual diagnosis patients under managed care.

The authors compared patterns of psychiatric hospitalization utilization and outcomes between persons with and without co-existing substance-related disorders in a managed care environment by means of a prospective follow-along study of persons hospitalized for psychiatric reasons under the auspices of a large regional managed care firm. Forty-two psychiatric inpatients with comorbid substance disorders and 121 inpatients without coexisting substance disorders were compared across measures of service use and psychiatric acuity. Readmission to the hospital was assessed at 30 days and after 6 months. Patients with coexisting substance disorders spent fewer days in the hospital, but were rehospitalized at a higher rate both within 30 days and (significantly) after 6 months. These results suggest that the revolving-door pattern of service utilization is also present in managed care environments.