Dataset Information

National trends and characteristics of inpatient detoxification for drug use disorders in the United States.

ABSTRACT: BACKGROUND:Prior studies indicate that the opportunity from detoxification to engage in subsequent drug use disorder (DUD) treatment may be missed. This study examined national trends and characteristics of inpatient detoxification for DUDs and explored factors associated with receiving DUD treatment (i.e., inpatient drug detoxification plus rehabilitation) and discharges against medical advice (DAMA). METHODS:We analyzed inpatient hospitalization data involving the drug detoxification procedure for patients aged?12 years (n =?271,403) in the 2003-2011 Nationwide Inpatient Samples. We compared the estimated rate and characteristics of inpatient drug-detoxification hospitalizations between 2003 and 2011 and determined demographic and clinical correlates of inpatient drug detoxification plus rehabilitation (versus detoxification-only) and DAMA (versus transfer to further treatment). RESULTS:There was no significant yearly change in the population rate of inpatient drug-detoxification hospitalizations during 2003-2011. The majority of inpatient drug detoxification were patients aged 35-64 years, males, and those on Medicaid. Among inpatient drug-detoxification hospitalizations, only 13% received detoxification plus rehabilitation during inpatient care, and up to 14% were DAMA; the most commonly identified diagnoses were opioid use disorder (OUD; 75%) and non-addiction mental health disorders (48%). Being on Medicaid (vs. having private insurance) and having OUD (vs. no OUD) were associated with decreased odds of receiving detoxification plus rehabilitation, as well as increased odds of DAMA. CONCLUSIONS:These findings suggest the presence of a potentially large detoxification-treatment gap for inpatient detoxification patients. They highlight the need for implementing DUD services to improve engagement in receiving further DUD treatment in order to improve recovery and health outcomes.

SUBMITTER: Zhu H

PROVIDER: S-EPMC6114033 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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National trends and characteristics of inpatient detoxification for drug use disorders in the United States.

Zhu He H Wu Li-Tzy LT

BMC public health 20180829 1

<h4>Background</h4>Prior studies indicate that the opportunity from detoxification to engage in subsequent drug use disorder (DUD) treatment may be missed. This study examined national trends and characteristics of inpatient detoxification for DUDs and explored factors associated with receiving DUD treatment (i.e., inpatient drug detoxification plus rehabilitation) and discharges against medical advice (DAMA).<h4>Methods</h4>We analyzed inpatient hospitalization data involving the drug detoxific ...[more]

PMID: 30157815

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Project description:BackgroundCardiac arrhythmias are associated with increased maternal morbidity. There are limited data on trends of arrhythmias among women hospitalized for delivery.Materials and methodsWe used the National Inpatient Sample (NIS) database to identify delivery hospitalizations for individuals aged 18-49 years between 2009 to 2019 and utilized coding data from the 9th and 10th editions of the International Classification of Diseases to identify supraventricular tachycardias (SVT), atrial fibrillation (AF), atrial flutter, ventricular tachycardia (VT), and ventricular fibrillation (VF). Arrhythmia trends were analyzed by age, race-ethnicity, hospital setting, and hospital geographic regions. Multivariable logistic regression was used to evaluate the association of demographic, clinical, and socioeconomic characteristics with arrhythmias.ResultsAmong 41,576,442 delivery hospitalizations, the most common arrhythmia was SVT (53%), followed by AF (31%) and VT (13%). The prevalence of arrhythmia among delivery hospitalizations increased between 2009 and 2019. Age > 35 years and Black race were associated with a higher arrhythmia burden. Factors associated with an increased risk of arrhythmias included valvular disease (OR: 12.77; 95% C1:1.98-13.61), heart failure (OR:7.13; 95% CI: 6.49-7.83), prior myocardial infarction (OR: 5.41, 95% CI: 4.01-7.30), peripheral vascular disease (OR: 3.19, 95% CI: 2.51-4.06), hypertension (OR: 2.18; 95% CI: 2.07-2.28), and obesity (OR 1.69; 95% CI: 1.63-1.76). Delivery hospitalizations complicated by arrhythmias compared with those with no arrhythmias had a higher proportion of all-cause in-hospital mortality (0.95% vs. 0.01%), cardiogenic shock (0.48% vs. 0.00%), preeclampsia (6.96% vs. 3.58%), and preterm labor (2.95% vs. 2.41%) (all p < 0.0001).ConclusionPregnant individuals with age > 35 years, obesity, hypertension, valvular heart disease, or severe pulmonary disease are more likely to have an arrhythmia history or an arrhythmia during a delivery hospitalization. Delivery hospitalizations with a history of arrhythmia are more likely to be complicated by all-cause in-hospital mortality, cardiovascular, and adverse pregnancy outcomes (APOs). These data highlight the increased risk associated with pregnancies among individuals with arrhythmias.

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Dataset Information

National trends and characteristics of inpatient detoxification for drug use disorders in the United States.

Publications

National trends and characteristics of inpatient detoxification for drug use disorders in the United States.

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