Magazine article Clinical Psychiatry News

Hospitalization More Likely for Veterans with Mental Illness

Magazine article Clinical Psychiatry News

Hospitalization More Likely for Veterans with Mental Illness

Article excerpt


SAN DIEGO -- Veterans aged 60 and younger with mental illnesses were more than twice as likely to be hospitalized, compared with their peers who had no psychiatric or addiction diagnosis, according to results of a large VA database study.

"Our patients sit at the center of two public health crises," David T. Moore, MD, PhD, said at the annual meeting and scientific symposium of the American Academy of Addiction Psychiatry. "One is the incredibly reduced life expectancy for adults with mental illnesses. There may be a 20-year reduced life expectancy. Their mortality rate for chronic medical conditions such as heart disease and chronic obstructive pulmonary disease is increased by two- to fourfold, and is associated with greater hospitalization rates, longer lengths of stay, and increased readmission rates.

"The second part of this crisis is the incredible cost associated with medical hospitalizations. About 1 in every $20 in the entire U.S. economy goes toward inpatient medical hospitalization."

In an effort to compare the risk of medical hospitalizations among veterans with and without mental health disorders, Dr. Moore, a psychiatrist at Yale University, New Haven, Conn., and his colleague, Robert Rosenheck, MD, identified 2,016,392 veterans under the age of 60 from the fiscal year 2012 Veterans Health Administration (VHA) databases. "We chose this group because it removes some confounding from nursing home visits, which also get coded in the VHA," he explained. "It also removes some confounding from dementias and associated psychoses that could confuse our data."

The final analysis included 952,252 veterans with a mental illness and 1,064,140 without a psychiatric or addiction diagnosis. Dr. Moore reported that, among veterans with mental illness, 100,191 (7.1%) were hospitalized on a medical unit at some point during the study period, compared with only 31,759 (2.9%) of veterans with no psychiatric or addiction diagnosis. The Charlson Comorbidity Index was significantly increased in veterans with mental health diagnoses, compared with those who did not have mental health diagnoses.

"There was more tobacco use; they were much more likely to receive an opioid prescription; [and] they used more outpatient medical services, whether it be primary care visits or specialty care visits," Dr. …

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