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Cost of comorbid alcohol and drug problems

S R Pirzada1, R Ries, J P LoGerfo

  • 1Health-Info Inc., Seattle, WA 98199, USA.

The American Journal on Addictions
|July 1, 1997
PubMed

Insights

Patients with alcohol and other drug (AOD) problems had significantly lower hospital charges and length of stay (LOS) across major diagnostic groups. This study highlights cost savings associated with AOD-affected patients in inpatient settings.

Area of Science:

  • Health Economics
  • Addiction Medicine
  • Hospital Administration

Background:

  • Comorbid alcohol and other drug (AOD) problems significantly impact healthcare utilization and costs.
  • Understanding the financial implications of AOD use in inpatient settings is crucial for resource allocation and treatment strategies.

Purpose of the Study:

  • To measure the comorbid effect of alcohol and other drug (AOD) problems on inpatient charges and length of stay (LOS).
  • To compare AOD-affected patients with non-AOD-affected patients regarding cost, diagnostic, demographic, and utilization variables.

Main Methods:

  • Retrospective study utilizing hospital clinical computer data from an urban hospital.
  • Analysis included 14,768 patients (men and women) with and without comorbid AOD problems, admitted for medical, surgical, and psychiatric reasons.
  • Comparison focused on total hospital charges and LOS for the 20 most frequent Diagnosis-Related Groups (DRGs).

Main Results:

  • Total hospital charges and LOS were significantly lower for patients with comorbid AOD problems across 10 of the 20 most frequent DRGs (P < 0.001).
  • Overall, the AOD group demonstrated robustly lower costs and LOS for the most frequent 20 DRGs.
  • Physicians perceived AOD-affected patients as often less ill within the same DRG compared to non-AOD patients.

Conclusions:

  • Alcohol and other drug-affected patients incurred significantly lower inpatient costs and shorter lengths of stay.
  • The current healthcare system, including fee-for-service DRGs, may inadvertently incentivize treating AOD-related sequelae without addressing the primary addiction.
  • Fragmentation of psychosocial and addiction treatment from general healthcare may create financial disincentives for comprehensive AOD care.

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