Abstract
Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders (β=0.31, P=0.001), referral to a hospital by a physician (β=0.35, P=0.014), and increasing age (β= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14–1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.
Highlights
Alcohol dependence has substantial consequences for individual and public health
The sample was almost evenly split between those with government-sponsored health insurance (36.9%) and those with private sector health insurance (38.3%). Among those without a co-morbid diagnosis of an episodic mood disorder, 39.2% were admitted to the hospital by a referring physician, 51.2% were admitted through the emergency department, 5.4% were admitted through law enforcement, and 4.2% through other sources
Among those with a co-morbid diagnosis of an episodic mood disorder, 26.5% were admitted to the hospital by a referring physician, 53.1% were admitted through the emergency department, 10.2% were admitted through law enforcement, and 10.2% through other sources
Summary
Association,[1] alcohol dependence exists when individuals continue to engage in excessive alcohol consumption despite severe personal consequences such as damage to health, relationships, career, and many other aspects of daily life Such excessive alcohol consumption can lead to several physical ailments such as stroke, heart disease, hypertension, and even brain damage.[2] Damage to internal organs such as the liver is reported by those who practice excessive alcohol consumption.[3] In addition to physical ailments, alcohol dependence is linked to a multitude of psychiatric disorders such as major depression, mania, panic disorders, schizophrenia, and even suicide.[2] A sub-set of these psychiatric disorders is identified by the ICD-9-CM4 as episodic mood disorders. As a result of alcohol related healthcare utilization, healthcare costs of alcohol dependency were estimated at nearly $30 billion in 2007.8
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