Posted on August 18, 2010 14:09
Categories: Medicare | Medicaid | Mental Health | Substance Abuse | Treatment and Recovery
Topics: Cost-effectiveness | Medicaid | Medicare | Mental Health | Spending | Substance Abuse | Treatment
The U.S. Agency for Healthcare Research and Quality (AHRQ) released a study finding that 12 million of 95 million emergency room (ER) visits in 2007, or 12.5 percent, were for MH/SUD related issues. Of those 12 million visits, 66 percent were for mental health issues, 25 percent were for substance abuse issues, and 9 percent were for co-occurring conditions. AHRQ also found that, of the ER visits related to MH/SUD issues, Medicare paid for 30 percent, private insurance paid 26 percent, Medicaid paid 20 percent, and 21 percent of the individuals were uninsured.
From the report:
An estimated one in three individuals has suffered from a mental health or substance abuse condition within the last 12 months,1 yet the community treatment system to support services for these individuals is regarded as ineffective.2 This is particularly evident in emergency department (ED) utilization. The number of patients with mental health and substance abuse (MHSA) conditions treated in EDs has been on the rise for more than a decade.3 Not only is this of concern to members of the mental health community, but also to the members of the emergency medicine community who are concerned that ED overcrowding results in decreased quality of care and increased likelihood of medical error.4 As a specific example, a 2008 American College of Emergency Physicians' ED directors’ survey reported that patients with MHSA conditions not only have had increased ED boarding times, but also that the resource-intensive care required for these patients has an impact on the quality of care for all other patients in the ED.5
This Statistical Brief presents data from the Healthcare Cost and Utilization Project (HCUP) Nationwide Emergency Department Sample (NEDS) on MHSA-related ED visits among adults in 2007. Specifically, patient and utilization characteristics of ED visits for MHSA are discussed and compared with all other types of ED visits. The distribution of MHSA-related ED visits are presented by age and primary expected payer. The MHSA conditions described here include those conditions found in the Diagnostic and Statistics Manual of Mental Disorders, Fourth Edition, excluding dementia and intellectual disabilities. The Brief also provides information about the types of MHSA conditions by age and primary expected payer. In addition to prevalence estimates, data on the likelihood of hospital admission are presented. Estimates are based on all-listed diagnoses. All differences between estimates noted in the text are statistically significant at the 0.05 level or better.
Full report: Mental Health and Substance Abuse-Related Emergency Department Visits Among Adults, 2007 (PDF | 271.3 KB) 
Agency for Healthcare Research and Quality. (2010). Mental health and substance abuse-related emergency department visits among adults, 2007. Owens, P.L., Mutter, R. and Stocks, C.
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