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Using Claims Data to Examine Hospital Readmission Risk in Patients With Schizophrenia and Comorbid Marijuana Use

Mary E Slaughter1,2, Coreen Farris2, Mark I Singer1

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This study found that alcohol use disorder (AUD) and other drug use disorder increase schizophrenia readmission risk. Marijuana use disorder did not significantly increase readmission rates in schizophrenia patients.

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Area of Science:

  • Psychiatry
  • Epidemiology
  • Addiction Medicine

Background:

  • Schizophrenia spectrum disorder (SSD) is often comorbid with substance use disorders.
  • Limited research exists on the impact of marijuana use disorder on repeated hospitalizations in SSD patients.

Purpose of the Study:

  • To investigate the association between marijuana use disorder and hospital readmission rates in patients with schizophrenia spectrum disorder.
  • To examine the influence of co-occurring alcohol use disorder (AUD) and other drug use disorder on readmission risk.

Main Methods:

  • Utilized linked California Health Care Cost and Utilization Project (CA HCUP) data from 4,349 SSD patients initially hospitalized in 2005.
  • Employed a stratified, recurrent-event, Cox proportional hazards model to analyze readmissions from 2005 to 2011.
  • Conducted sensitivity analyses on patients readmitted in 2010 or 2011.

Main Results:

  • Marijuana use disorder alone or AUD alone was associated with longer time to first readmission.
  • Recent marijuana use disorder showed a decreased risk of readmission through the fifth event (HR=0.92), but not beyond.
  • Recent other drug use disorder increased readmission risk for the second to fifth hospitalizations (HR=1.13).
  • Recent AUD increased readmission risk for the sixth or greater hospitalization (HR=1.15).

Conclusions:

  • Alcohol use disorder and other drug use disorder are associated with increased hospital readmission risk in schizophrenia patients.
  • Marijuana use disorder does not appear to elevate the risk of hospital readmission in this population.
  • Findings highlight the differential impact of various substance use disorders on schizophrenia patient outcomes.