A missed opportunity: underutilization of inpatient behavioral health services to reduce injection drug use sequelae in Florida

Austin E Coye,Kasha J Bornstein,Hansel E Tookes,Mackenzie T Jones,Joan E St Onge

doi:10.1186/s13011-021-00383-w

Austin E Coye, Kasha J Bornstein + Show 3 more

Open Access

https://doi.org/10.1186/s13011-021-00383-w

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Abstract

BackgroundPeople who inject drugs (PWID) suffer high morbidity and mortality from injection related infections (IRI). The inpatient setting is an ideal opportunity to treat underlying substance use disorder (SUD), but it is unclear how often this occurs.ObjectivesTo quantify the utilization of behavioral health services for PWID during inpatient admissions for IRI.MethodsData for all hospital admissions in Florida in FY2017 were obtained from the Agency for Healthcare Administration. Hospitalization for IRI were obtained using a validated ICD-10 algorithm and treatment for substance use disorder was quantified using ICD-10-Procedure Coding System (ICD-10-PCS) codes.ResultAmong the 20,001 IRI admissions, there were 230 patients who received behavioral health services as defined by ICD-10-PCS SAT codes for treatment for SUD.ConclusionsIn a state with a large number of IRI, only a very small portion of admissions received behavioral health services. Increased efforts should be directed to studying referral patterns among physicians and other providers caring for this population and increasing utilization of behavioral health services.

Highlights

People who inject drugs (PWID) suffer high morbidity and mortality from injection related infections (IRI)
We conducted a retrospective review of patients hospitalized for IRI in Florida during Fiscal Year 2017 (FY2017), using the Agency for Health Care Administration (AHCA) Hospital Inpatient Limited Data Set
Medication management and pharmacotherapy for Substance Addiction Treatment (SAT) comprised nicotine replacement, methadone, levo-alpha-acetylmethadol, disulfiram, naltrexone, naloxone, clonidine, bupropion, psychiatric medication, and nicotine replacement medications. This analysis includes 20,001 PWID admitted to Florida hospitals during FY2017 for IRI

Summary

Introduction

People who inject drugs (PWID) suffer high morbidity and mortality from injection related infections (IRI). Objectives: To quantify the utilization of behavioral health services for PWID during inpatient admissions for IRI. Result: Among the 20,001 IRI admissions, there were 230 patients who received behavioral health services as defined by ICD-10PCS SAT codes for treatment for SUD. People who inject drugs (PWID) are a vulnerable patient population who often require recurrent hospitalization for sequelae of drug use [1,2,3,4] This vulnerable population experiences increased mortality risk after hospitalization as well as high risk for readmission [5]. Peterson et al found that identifying patients with SUD while in-hospital is an effective method to target prevention services that reduce opioid-related morbidity and mortality [12].

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