Background
Methods
Data source
Study sample
Study variables
Inpatient drug detoxification-only and detoxification plus rehabilitation
DAMA, routine discharge, and transfer to further treatment
Diagnosis of substance use and mental health disorders
Demographic and hospital characteristics
Data analyses
Results
Trends and demographic characteristics of inpatient drug-detoxification hospitalizations (Fig. 1 and Table 1)
Year | Overall (2003–2011) | 2003 | 2011 | p value‡ | |||
---|---|---|---|---|---|---|---|
Sample size, unweighted N | 271,403 | 27,626 | 28,692 | ||||
Weighted N | 1,284,276 | 128,277 | 131,371 | ||||
Weighted column, % | % | (95% CI) | % | (95% CI) | % | (95% CI) | |
Mean of age, years | 38.79 | 38.29–39.29 | 37.24 | 35.91–38.57 | 39.94 | 38.17–41.71 |
0.017
|
Age group, years |
< 0.001
| ||||||
12–17 | 0.73 | (0.45–1.18) | 1.19 | (0.57–2.48) | 0.53 | (0.17–1.63) | |
18–25 | 13.95 | (12.82–15.17) | 14.94 | (11.16–19.72) | 14.89 | (11.65–18.83) | |
26–34 | 22.53 | (21.54–23.54) | 24.92 | (22.90–27.05) | 23.02 | (19.46–27.01) | |
35–49 | 45.01 | (43.45–46.58) | 46.74 | (42.32–51.20) | 36.99 | (33.03–41.13) | |
50–64 | 16.24 | (15.21–17.32) | 10.93 | (9.21–12.92) | 22.17 | (18.38–26.50) | |
65+ | 1.55 | (1.36–1.76) | 1.29 | (0.83–1.99) | 2.41 | (1.71–3.37) | |
Sex | 0.286 | ||||||
Male | 65.27 | (63.97–66.55) | 63.02 | (60.03–65.92) | 64.82 | (61.52–67.98) | |
Female | 34.60 | (33.34–35.89) | 36.69 | (33.85–39.62) | 35.10 | (31.96–38.38) | |
Race/Ethnicity |
0.001
| ||||||
White, non-Hispanic | 44.77 | (41.18–48.41) | 44.57 | (34.68–54.90) | 53.98 | (42.42–65.13) | |
Black, non-Hispanic | 20.74 | (17.78–24.05) | 14.58 | (9.80–21.14) | 27.19 | (17.69–39.36) | |
Hispanic | 9.63 | (7.69–12.00) | 8.13 | (5.10–12.74) | 7.60 | (5.03–11.33) | |
Asian/Pacific-Islander/Native-American | 0.67 | (0.52–0.87) | 0.34 | (0.21–0.55) | 0.99 | (0.47–2.10) | |
Other races, non-Hispanic | 3.85 | (2.80–5.27) | 4.30 | (1.59–11.11) | 3.87 | (1.81–8.09) | |
Unknowna | 16.78 | (13.46-20.72) | 23.28 | (12.83–38.47) | 4.40 | (1.72–10.77) | |
Household income | 0.731 | ||||||
Lowest quartile | 36.41 | (33.55–39.36) | 33.25 | (25.96–41.43) | 33.51 | (26.23–41.67) | |
2nd quartile | 20.75 | (19.46–22.11) | 24.98 | (21.17–29.23) | 21.09 | (17.64–25.00) | |
3rd quartile | 18.72 | (17.28–20.26) | 20.27 | (16.26–24.96) | 20.60 | (17.47–24.13) | |
Highest quartile | 17.66 | (15.96–19.49) | 17.14 | (13.29–21.82) | 19.39 | (15.16–24.47) | |
Primary expected payer | 0.219 | ||||||
Medicare | 11.89 | (11.10–12.74) | 11.19 | (8.45–14.67) | 14.02 | (10.85–17.92) | |
Medicaid | 39.89 | (36.03–43.87) | 28.68 | (19.99–39.28) | 40.37 | (30.77–50.76) | |
Private | 22.72 | (20.44–25.18) | 28.86 | (21.43–37.64) | 21.74 | (15.95–28.91) | |
Self-pay | 18.53 | (15.78–21.62) | 19.65 | (11.64–31.22) | 17.66 | (10.19–28.85) | |
Other payers | 6.76 | (5.48–8.32) | 11.52 | (6.34–20.02) | 6.04 | (3.48–10.30) | |
Hospital region | 0.793 | ||||||
Northeast | 44.02 | (38.66–49.51) | 41.70 | (26.61–58.53) | 36.80 | (23.99–51.78) | |
Midwest | 20.44 | (16.44–25.12) | 20.71 | (11.21–35.08) | 18.15 | (8.62–34.25) | |
South | 25.02 | (21.12–29.38) | 22.87 | (14.38–34.35) | 31.51 | (20.13–45.64) | |
West | 10.52 | (8.60–12.81) | 14.72 | (8.65–23.92) | 13.54 | (7.25–23.90) | |
Hospital location | 0.126 | ||||||
Rural | 6.99 | (5.36–9.07) | 10.81 | (4.90–22.17) | 5.05 | (2.70–9.27) | |
Urban | 92.88 | (90.80–94.52) | 89.19 | (77.83–95.10) | 94.83 | (90.61–97.22) | |
Detoxification procedure array | 0.817 | ||||||
Primary procedure | 96.48 | (95.74–97.10) | 96.57 | (94.85–97.73) | 96.83 | (94.65–98.14) | |
Secondary procedure | 3.52 | (2.90–4.26) | 3.43 | (2.27–5.15) | 3.17 | (1.86–5.35) | |
Detoxification and treatment | 0.157 | ||||||
Drug detoxification-only | 87.45 | (84.58–89.85) | 79.82 | (68.08–88.01) | 88.47 | (79.32–93.88) | |
Drug detoxification plus rehabilitation | 12.55 | (10.15–15.42) | 20.18 | (11.99–31.92) | 11.53 | (6.12–20.68) | |
Discharge statusb |
0.007
| ||||||
Routine discharge | 76.65 | (75.23–78.00) | 79.06 | (76.04–81.80) | 75.01 | (69.62–79.72) | |
Transfer to further treatment | 9.44 | (8.41–10.57) | 6.79 | (4.92–9.30) | 12.57 | (8.91–17.44) | |
Discharges against medical advice (DAMA) | 13.67 | (12.69–14.72) | 13.62 | (11.29–16.33) | 12.30 | (10.00–15.05) |
Trends in clinical characteristics of inpatient drug-detoxification hospitalizations (Table 2)
Year | Overall (2003–2011) | 2003 | 2011 | p value‡ | |||
---|---|---|---|---|---|---|---|
Sample size, unweighted N | 271,403 | 27,626 | 28,692 | ||||
Weighted column, % | % | (95% CI) | % | (95% CI) | % | (95% CI) | |
Any-listed diagnosis | |||||||
Any drug use disorder | 99.13 | (98.96–99.28) | 99.12 | (98.82–99.35) | 99.18 | (98.71–99.48) | 0.811 |
Drug withdrawal | 47.45 | (42.85–52.09) | 34.71 | (23.76–47.56) | 52.67 | (41.57–63.52) | 0.037 |
Opioid use disorders | 74.83 | (72.70–76.85) | 72.37 | (63.93–79.47) | 75.60 | (68.64–81.43) | 0.529 |
Stimulant use disordersa | 30.06 | (27.63–32.61) | 25.27 | (19.71–31.79) | 28.62 | (22.89–35.14) | 0.447 |
Sedative use disorders | 13.21 | (11.99–14.52) |
9.65
|
(7.27–12.69)
|
17.74
|
(13.28–23.31)
|
0.003
|
Cannabis use disorders | 12.14 | (11.09–13.28) | 10.19 | (7.40–13.89) | 14.26 | (11.48–17.57) | 0.081 |
Other drug-related disordersb | 11.87 | (10.75–13.08) | 12.90 | (9.83–16.76) | 11.08 | (8.66–14.07) | 0.409 |
Alcohol use disorders | 42.37 | (39.41–45.38) | 35.68 | (29.05–42.90) | 41.32 | (32.54–50.69) | 0.334 |
Any non-addiction mental health disorder | 47.93 | (45.29–50.59) |
43.16
|
(35.30–51.38)
|
58.98
|
(51.82–65.78)
|
0.004
|
Mood disorders | 38.35 | (36.08–40.67) | 34.66 | (28.25–41.67) | 46.42 | (40.39–52.55) | 0.013 |
Schizophrenic/psychotic/ delusional disorders | 3.94 | (3.58–4.32) | 3.35 | (2.49–4.48) | 5.19 | (3.74–7.15) | 0.048 |
Anxiety disorders | 10.82 | (9.89–11.81) |
8.17
|
(6.53–10.18)
|
17.38
|
(13.90–21.53)
|
< 0.001
|
Adjustment disorders | 0.95 | (0.79–1.13) | 1.09 | (0.79–1.50) | 1.26 | (0.51–3.08) | 0.761 |
Personality/impulse-control/disruptive behavior disorders | 7.12 | (6.29–8.04) | 7.39 | (5.55–9.78) | 7.81 | (5.74–10.54) | 0.795 |
Primary diagnosis | |||||||
Any drug use disorder | 71.26 | (68.79–73.61) | 71.73 | (64.93–77.67) | 64.53 | (55.84–72.35) | 0.175 |
Drug withdrawal | 33.68 | (29.28–38.38) | 24.60 | (14.85–37.89) | 35.37 | (24.36–48.19) | 0.214 |
Opioid use disorders | 27.27 | (24.12–30.66) | 36.95 | (25.52–50.06) | 20.51 | (15.07–27.29) | 0.013 |
Stimulant use disordersa | 5.45 | (3.95–7.48) | 5.16 | (3.38–7.80) | 4.38 | (2.18–8.61) | 0.688 |
Sedative use disorders | 1.38 | (1.15–1.67) | 1.21 | (0.85–1.71) | 1.68 | (1.05–2.68) | 0.266 |
Cannabis use disorders | 0.34 | (0.23–0.49) | 0.54 | (0.18–1.61) | 0.31 | (0.12–0.76) | 0.443 |
Other drug-related disordersb | 3.14 | (2.68–3.67) | 3.27 | (2.39–4.47) | 2.28 | (1.63–3.18) | 0.119 |
Alcohol use disorders | 12.45 | (11.07–13.96) | 11.53 | (8.66–15.20) | 15.70 | (10.32–23.16) | 0.223 |
Any non-addiction mental health disorder | 11.07 | (9.60–12.72) | 11.83 | (8.68–15.92) | 15.08 | (9.90–22.80) | 0.351 |
Mood disorders | 9.22 | (8.00–10.60) | 9.67 | (7.03–13.16) | 12.43 | (8.37–18.05) | 0.323 |
Schizophrenic/psychotic/ delusional disorders | 1.21 | (1.01–1.45) | 1.41 | (0.95–2.09) | 1.37 | (0.82–2.26) | 0.922 |
Anxiety disorders | 0.26 | (0.19–0.36) | 0.29 | (0.15–0.59) | 0.54 | (0.16–1.85) | 0.391 |
Adjustment disorders | 0.30 | (0.20–0.44) | 0.37 | (0.22–0.62) | 0.70 | (0.16–2.98) | 0.414 |
Personality/impulse-control/disruptive behavior disorders | 0.08 | (0.05–0.15) | 0.08 | (0.04–0.16) | 0.05 | (0.02–0.14) | 0.377 |
Secondary diagnosis | |||||||
Any drug use disorder | 80.16 | (77.10–82.90) |
68.08
|
(57.56–77.03)
|
87.04
|
(81.71–90.99)
|
< 0.001
|
Drug withdrawal | 13.77 | (11.97–15.80) | 10.11 | (7.14–14.15) | 17.33 | (12.10–24.19) | 0.030 |
Opioid use disorders | 47.73 | (43.88–51.60) |
35.59
|
(25.86–46.67)
|
55.25
|
(45.23–64.86)
|
0.009
|
Stimulant use disordersa | 24.79 | (23.05–26.62) | 20.41 | (16.28–25.27) | 24.35 | (19.77–29.60) | 0.246 |
Sedative use disorders | 11.83 | (10.72–13.04) |
8.44
|
(6.25–11.32)
|
16.07
|
(12.13–20.99)
|
0.002
|
Cannabis use disorders | 11.81 | (10.81–12.89) | 9.66 | (7.15–12.93) | 13.95 | (11.29–17.12) | 0.044 |
Other drug-related disordersb | 9.12 | (8.30–10.00) | 10.04 | (7.53–13.26) | 9.11 | (7.09–11.64) | 0.615 |
Alcohol use disorders | 36.12 | (33.34–38.99) | 29.44 | (23.79–35.81) | 33.63 | (26.96–41.04) | 0.375 |
Any non-addiction mental health disorder | 41.38 | (39.24–43.55) |
35.40
|
(29.13–42.22)
|
50.67
|
(44.93–56.40)
|
0.001
|
Mood disorders | 29.74 | (28.08–31.45) |
25.47
|
(20.90–30.65)
|
34.82
|
(30.19–39.77)
|
0.008
|
Schizophrenic/psychotic/ delusional disorders | 2.81 | (2.53–3.13) |
1.99
|
(1.47–2.69)
|
4.00
|
(2.75–5.79)
|
0.004
|
Anxiety disorders | 10.60 | (9.70–11.57) |
7.90
|
(6.31–9.85)
|
16.98
|
(13.68–20.88)
|
< 0.001
|
Adjustment disorders | 0.65 | (0.56–0.75) | 0.72 | (0.48–1.07) | 0.57 | (0.40–0.80) | 0.378 |
Personality/impulse-control/disruptive behavior disorders | 7.07 | (6.25–7.98) | 7.33 | (5.50–9.71) | 7.77 | (5.71–10.50) | 0.785 |
Inpatient drug detoxification plus rehabilitation vs. detoxification-only (Table 3)
Drug treatment | Drug detoxification-only | Drug detoxification plus rehabilitation | Drug detoxification plus rehabilitation (1) vs. drug detoxification-only (0) | ||||
---|---|---|---|---|---|---|---|
Sample size, unweighted N (weighted row %) | 236,682 (87.45%) | 34,721 (12.55%) | 242,476b | ||||
Weighted column %/Adjusted odds ratio (AOR) | % | (95% CI) | % | (95% CI) | AOR | (95% CI) | p value‡ |
Age group, years | |||||||
12–17 | 0.52 | (0.34–0.78) | 2.22 | (1.00–4.86) |
2.72
|
(1.43–5.17)
|
0.002
|
18–25 | 13.29 | (12.12–14.56) | 18.56 | (16.31–21.04) | 1.00 | ||
26–34 | 22.33 | (21.28–23.41) | 23.89 | (21.93–25.96) | 0.88 | (0.79–0.98) | 0.015 |
35–49 | 46.06 | (44.45–47.68) | 37.69 | (34.65–40.82) |
0.70
|
(0.62–0.78)
|
< 0.001
|
50–64 | 16.40 | (15.28–17.58) | 15.12 | (13.53–16.86) |
0.67
|
(0.58–0.78)
|
< 0.001
|
65+ | 1.41 | (1.27–1.56) | 2.53 | (1.78–3.59) | 0.75 | (0.52–1.08) | 0.118 |
Sex | |||||||
Male | 65.90 | (64.50–67.27) | 60.91 | (58.66–63.12) | 1.00 | ||
Female | 34.00 | (32.64–35.39) | 38.80 | (36.63–41.02) | 1.02 | (0.95–1.09) | 0.601 |
Race/Ethnicity | |||||||
White, non-Hispanic | 42.85 | (39.13–46.64) | 58.15 | (50.62–65.32) | 1.00 | ||
Black, non-Hispanic | 22.29 | (19.08–25.87) | 9.96 | (7.20–13.62) |
0.63
|
(0.46–0.87)
|
0.005
|
Hispanic | 10.41 | (8.25–13.06) | 4.21 | (2.77–6.35) |
0.48
|
(0.33–0.71)
|
< 0.001
|
Asian/Pacific-Islander/Native-American | 0.66 | (0.49–0.87) | 0.79 | (0.49–1.30) | 0.65 | (0.38–1.11) | 0.113 |
Other races, non-Hispanic | 4.18 | (3.00–5.79) | 1.53 | (1.10–2.12) |
0.50
|
(0.31–0.81)
|
0.005
|
Unknowna | 16.44 | (12.98-20.61) | 19.11 | (12.2–28.65) | 0.84 | (0.48–1.48) | 0.557 |
Household income | |||||||
Lowest quartile | 37.30 | (34.26–40.45) | 30.15 | (24.52–36.45) | 1.00 | ||
2nd quartile | 20.77 | (19.38–22.23) | 20.63 | (17.90–23.65) | 0.90 | (0.74–1.09) | 0.272 |
3rd quartile | 18.13 | (16.59–19.78) | 22.87 | (20.26–25.70) | 1.11 | (0.91–1.35) | 0.308 |
Highest quartile | 16.87 | (15.15–18.75) | 23.14 | (18.76–28.19) | 1.09 | (0.85–1.41) | 0.493 |
Primary expected payer | |||||||
Medicare | 10.94 | (10.21–11.72) | 18.53 | (15.54–21.94) | 1.07 | (0.83–1.36) | 0.612 |
Medicaid | 42.63 | (38.50–46.87) | 20.74 | (14.79–28.29) |
0.42
|
(0.27–0.64)
|
< 0.001
|
Private | 20.05 | (17.90–22.38) | 41.38 | (35.29–47.74) | 1.00 | ||
Self-pay | 19.23 | (16.18–22.70) | 13.61 | (9.58–18.97) |
0.40
|
(0.25–0.64)
|
< 0.001
|
Other payers | 6.93 | (5.51–8.69) | 5.57 | (4.20–7.34) |
0.40
|
(0.27–0.59)
|
< 0.001
|
Hospital region | |||||||
Northeast | 46.28 | (40.45–52.20) | 28.27 | (18.61–40.45) | 1.00 | ||
Midwest | 21.01 | (16.65–26.15) | 16.47 | (10.95–24.02) | 1.02 | (0.49–2.12) | 0.968 |
South | 24.16 | (19.99–28.88) | 31.05 | (22.29–41.40) | 1.42 | (0.77–2.63) | 0.261 |
West | 8.56 | (6.91–10.55) | 24.21 | (16.53–34.01) | 2.52 | (1.17–5.47) | 0.019 |
Hospital location | |||||||
Rural | 5.57 | (4.30–7.19) | 16.90 | (9.88–27.41) | 1.00 | ||
Urban | 94.33 | (92.71–95.61) | 82.75 | (72.28–89.82) |
0.32
|
(0.18–0.58)
|
< 0.001
|
Any-listed alcohol use disorder | |||||||
No | 57.98 | (54.61–61.28) | 55.23 | (50.92–59.47) | 1.00 | ||
Yes | 42.02 | (38.72–45.39) | 44.77 | (40.53–49.08) |
1.30
|
(1.13–1.50)
|
< 0.001
|
Any-listed opioid use disorder | |||||||
No | 23.97 | (21.85–26.22) | 33.56 | (29.04–38.40) | 1.00 | ||
Yes | 76.03 | (73.78–78.15) | 66.44 | (61.60–70.96) |
0.75
|
(0.63–0.89)
|
0.001
|
Any-listed any non-addiction mental health disorderc | |||||||
No | 53.78 | (51.01–56.53) | 40.12 | (34.69–45.80) | 1.00 | ||
Yes | 46.22 | (43.47–48.99) | 59.88 | (54.20–65.31) | 1.18 | (0.94–1.48) | 0.149 |
DAMA vs. routine and transfer discharges (Table 4)
Detoxification discharge status | DAMA | Routine | Transfer to further treatment | DAMA (1) vs. routine (0) | DAMA (1) vs. transfer to further treatment (0) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Sample size, unweighted N (weighted row %) | 36,885 (13.67%) | 208,291 (76.65%) | 25,566 (9.44%) | 219,536b | 54,832b | |||||||
Weighted column %/Adjusted odds ratio (AOR) | % | (95% CI) | % | (95% CI) | % | (95% CI) | AOR | (95% CI) | p value‡ | AOR | (95% CI) | p value‡ |
Age group, years | ||||||||||||
12–17 | 0.25 | (0.16–0.40) | 0.79 | (0.47–1.34) | 0.91 | (0.59–1.42) |
0.39
|
(0.26–0.57)
|
< 0.001
|
0.34
|
(0.19–0.61)
|
< 0.001
|
18–25 | 16.16 | (14.42–18.07) | 13.56 | (12.41–14.79) | 13.82 | (12.51–15.24) | 1.00 | 1.00 | ||||
26–34 | 27.20 | (25.96–28.48) | 21.94 | (20.86–23.05) | 20.51 | (19.45–21.62) | 0.98 | (0.93–1.03) | 0.469 | 1.06 | (0.98–1.16) | 0.157 |
35–49 | 44.65 | (42.43–46.88) | 45.30 | (43.68–46.94) | 43.39 | (41.34–45.46) |
0.72
|
(0.67–0.78)
|
< 0.001
|
0.85
|
(0.76–0.94)
|
0.003
|
50–64 | 11.17 | (10.10–12.34) | 16.89 | (15.77–18.08) | 18.17 | (16.99–19.42) |
0.53
|
(0.48–0.58)
|
< 0.001
|
0.56
|
(0.49–0.63)
|
< 0.001
|
65+ | 0.57 | (0.45–0.71) | 1.51 | (1.32–1.73) | 3.19 | (2.64–3.84) |
0.33
|
(0.27–0.40)
|
< 0.001
|
0.18
|
(0.14–0.24)
|
< 0.001
|
Sex | ||||||||||||
Male | 70.99 | (69.35–72.57) | 64.30 | (62.99–65.58) | 64.91 | (63.01–66.76) | ||||||
Female | 28.87 | (27.29–30.49) | 35.58 | (34.31–36.87) | 35.00 | (33.16–36.89) |
0.88
|
(0.85–0.91)
|
< 0.001
|
0.85
|
(0.80–0.91)
|
< 0.001
|
Race/Ethnicity | ||||||||||||
White, non-Hispanic | 43.23 | (38.42–48.18) | 44.48 | (40.77–48.24) | 48.73 | (44.72–52.77) | 1.00 | 1.00 | ||||
Black, non-Hispanic | 19.98 | (16.75–23.66) | 20.94 | (17.70–24.61) | 20.54 | (17.31–24.20) | 0.84 | (0.74–0.96) | 0.011 | 1.03 | (0.85–1.25) | 0.762 |
Hispanic | 13.15 | (9.70–17.60) | 8.97 | (7.18–11.17) | 9.95 | (7.86–12.53) | 0.98 | (0.86–1.12) | 0.758 | 1.11 | (0.83–1.47) | 0.481 |
Asian/Pacific-Islander/Native-American | 0.63 | (0.46–0.86) | 0.68 | (0.52–0.90) | 0.65 | (0.50–0.85) | 1.02 | (0.79–1.32) | 0.851 | 1.37 | (1.01–1.85) | 0.044 |
Other races, non-Hispanic | 5.52 | (3.68–8.20) | 3.54 | (2.56–4.87) | 3.95 | (2.87–5.40) | 1.07 | (0.88–1.31) | 0.490 | 1.25 | (0.95–1.66) | 0.112 |
Unknowna | 14.21 | (10.74-18.57) | 17.81 | (14.20–22.10) | 12.39 | (9.66–15.76) | 1.07 | (0.88–1.31) | 0.485 | 1.24 | (0.90–1.69) | 0.183 |
Household income | ||||||||||||
Lowest quartile | 37.70 | (33.71–41.87) | 36.93 | (34.05–39.92) | 30.66 | (27.26–34.28) | 1.00 | 1.00 | ||||
2nd quartile | 19.81 | (17.95–21.82) | 20.90 | (19.65–22.21) | 21.03 | (18.68–23.59) | 1.00 | (0.93–1.07) | 0.938 | 0.79 | (0.65–0.95) | 0.012 |
3rd quartile | 17.03 | (15.28–18.93) | 18.65 | (17.32–20.06) | 21.62 | (18.24–25.43) | 0.93 | (0.86–1.00) | 0.055 |
0.66
|
(0.51–0.86)
|
0.002
|
Highest quartile | 16.94 | (14.34–19.91) | 17.68 | (15.99–19.50) | 18.14 | (15.99–20.50) |
0.90
|
(0.81–1.00)
|
0.060
|
0.78
|
(0.66–0.93)
|
0.006
|
Primary expected payer | ||||||||||||
Medicare | 9.08 | (8.21–10.04) | 11.98 | (11.20–12.80) | 15.13 | (13.36–17.09) |
1.62
|
(1.50–1.75)
|
< 0.001
|
1.38
|
(1.20–1.59)
|
< 0.001
|
Medicaid | 47.27 | (42.00–52.60) | 38.61 | (34.70–42.67) | 39.92 | (35.29–44.74) |
1.64
|
(1.49–1.81)
|
< 0.001
|
1.60
|
(1.33–1.91)
|
< 0.001
|
Private | 14.85 | (12.75–17.24) | 23.89 | (21.46–26.50) | 24.35 | (21.30–27.68) | 1.00 | 1.00 | ||||
Self-pay | 22.08 | (18.33–26.35) | 18.67 | (15.78–21.96) | 12.34 | (10.76–14.13) |
1.68
|
(1.49–1.89)
|
< 0.001
|
2.43
|
(1.94–3.06)
|
< 0.001
|
Other payers | 6.57 | (4.74–9.04) | 6.62 | (5.41–8.07) | 8.07 | (5.81–11.12) |
1.70
|
(1.35–2.13)
|
< 0.001
| 0.99 | (0.74–1.33) | 0.954 |
Hospital region | ||||||||||||
Northeast | 58.49 | (51.60–65.06) | 40.51 | (35.16–46.09) | 51.11 | (44.61–57.58) | 1.00 | 1.00 | ||||
Midwest | 16.41 | (12.45–21.31) | 22.04 | (17.65–27.17) | 13.67 | (10.98–16.88) |
0.60
|
(0.50–0.72)
|
< 0.001
| 1.30 | (0.89–1.90) | 0.180 |
South | 17.01 | (12.68–22.43) | 27.08 | (22.91–31.69) | 20.37 | (16.55–24.79) |
0.53
|
(0.44–0.63)
|
< 0.001
| 1.01 | (0.72–1.41) | 0.967 |
West | 8.10 | (6.25–10.44) | 10.37 | (8.47–12.64) | 14.86 | (11.11–19.59) |
0.77
|
(0.65–0.92)
|
0.004
| 0.78 | (0.57–1.06) | 0.115 |
Hospital location | ||||||||||||
Rural | 5.87 | (3.93–8.67) | 7.01 | (5.36–9.14) | 8.57 | (6.20–11.72) | 1.00 | 1.00 | ||||
Urban | 94.10 | (91.30–96.04) | 92.84 | (90.71–94.50) | 91.34 | (88.19–93.71) | 1.04 | (0.81–1.33) | 0.768 |
1.75
|
(1.28–2.40)
|
< 0.001
|
Any-listed alcohol use disorder | ||||||||||||
No | 55.93 | (51.94–59.85) | 59.05 | (55.91–62.12) | 48.59 | (45.67–51.51) | 1.00 | 1.00 | ||||
Yes | 44.07 | (40.15–48.06) | 40.95 | (37.88–44.09) | 51.41 | (48.49–54.33) |
1.13
|
(1.06–1.21)
|
< 0.001
|
0.83
|
(0.75–0.92)
|
< 0.001
|
Any-listed opioid use disorder | ||||||||||||
No | 18.92 | (16.60–21.47) | 25.36 | (23.21–27.63) | 32.61 | (29.82–35.53) | 1.00 | 1.00 | ||||
Yes | 81.08 | (78.53–83.40) | 74.64 | (72.37–76.79) | 67.39 | (64.47–70.18) |
1.33
|
(1.23–1.45)
|
< 0.001
|
1.73
|
(1.49–2.02)
|
< 0.001
|
Any-listed any non-addiction mental health disorderc | ||||||||||||
No | 67.58 | (65.03–70.03) | 50.19 | (47.39–52.99) | 45.03 | (41.95–48.14) | 1.00 | 1.00 | ||||
Yes | 32.42 | (29.97–34.97) | 49.81 | (47.01–52.61) | 54.97 | (51.86–58.05) |
0.58
|
(0.54–0.62)
|
< 0.001
|
0.46
|
(0.42–0.51)
|
< 0.001
|