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. 2023 Jan-Feb;17(1):42-46.
doi: 10.1097/ADM.0000000000001026. Epub 2022 Aug 2.

Addiction Services for Veterans: Opportunities in Acute Care

Meghna N Shah  1 , Helene Starks, Pandora L Wander, Andrew J Saxon
Affiliations

Addiction Services for Veterans: Opportunities in Acute Care

Meghna N Shah et al. J Addict Med. 2023 Jan-Feb.

Abstract

Objective: This study aimed to estimate the proportion of total hospital discharges that involved a primary or secondary substance-related diagnosis code (SubDx) on inpatient medicine, psychiatry, and surgery services as part of a needs assessment for inpatient addiction consultation at our large, academic-affiliated Veterans Affairs (VA) hospital.

Methods: We first calculated the percentage of total and service-specific discharges with a primary or secondary substance-related International Classification of Disease, Tenth Revision , code on all inpatient services (medicine, psychiatry, and surgery) in Fiscal Year 2017, 2018, and 2019, using facility-level data. Second, we calculated the proportion of total discharges that involved alcohol- and opioid-related diagnoses.

Results: Over the 3 years studied, 29% of total discharges had a SubDx (4469 of 15,575). The proportion of total discharges that involved a SubDx was 23% (1246 of 5449) in 2017, 31% (1664 of 5332) in 2018, and 33% in 2019 (1559 of 4794), a statistically significant increase ( P < 0.001). As a percentage of service-specific discharges, 65% of discharges from psychiatry (1446 of 2217) had a SubDx, compared with 25% from medicine (2469 of 9713), and 15% from surgery (554 of 3645). Medicine services had the most discharges with SubDx, with a year-over-year increase in the number of discharges with SubDx. The percentage of total discharges that involved alcohol- and opioid-related diagnoses was 14% and 4%, respectively.

Conclusions: Substance-related diagnoses are prevalent at our hospital and are increasing over time. The largest number of discharges with SubDx was found on medicine services. Alcohol-related diagnoses were nearly 4 times more prevalent than opioid-related diagnoses. We found focused need around alcohol use and alcohol withdrawal.

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Conflict of interest statement

A.J.S. has received travel support from Alkermes, Inc., royalties from UpToDate, Inc., consulting fees from Indivior, Inc., and research support from Medicasafe, Inc. No other authors have conflicts of interest to report.

References

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