Alcohol and Drug Abuse Resource Utilization in the ICU

Area of Science:

• Medical research
• Public health
• Healthcare economics

Background:

• Substance use disorders are leading causes of illness and death with substantial societal costs.
• Effective treatment for substance use disorders yields significant healthcare cost savings.
• Understanding healthcare resource utilization in this population can reveal disease burden and intervention points.

Purpose of the Study:

• To characterize the healthcare resource utilization of patients admitted to the ICU due to alcohol or drug abuse complications.
• To compare resource utilization between substance abuse patients and the general ICU population.
• To identify opportunities for intervention in patients with substance use disorders.

Main Methods:

• Retrospective chart review of ICU admissions from July 1, 2017, to December 31, 2017.
• Collection of demographic, clinical, and healthcare resource utilization data.
• Analysis of 737 ICU admissions, with 158 (21%) linked to alcohol or drug abuse.

Main Results:

• Substance abuse patients were younger (average age 50) than the general ICU cohort (average age 66).
• Healthcare resource utilization, including ICU length of stay, was similar between cohorts.
• Total hospital charges for the substance abuse cohort exceeded $7 million over six months.
• Nearly half of substance abuse patients had prior ER visits, often multiple.
• Few patients (8%) transferred to inpatient rehab, primarily those with comorbid psychiatric conditions.

Conclusions:

• Patients with alcohol and drug abuse disorders place a high burden on ICU resources, comparable to older patients with other diseases.
• Intervention for substance use disorders is infrequent unless comorbid psychiatric conditions are present.
• Prior ER visits and hospital admissions present opportunities for early intervention in this population.