Recurrent use of inpatient withdrawal management services: Characteristics, service use, and cost among Medicaid clients.
Reducing repeat use of costly inpatient services, such as inpatient withdrawal management, among Medicaid members is a target of healthcare reform. However, characteristics of frequent users of inpatient withdrawal management are understudied. We described the characteristics, service utilization, and costs of New York Medicaid clients who use withdrawal management services by analyzing data from Medicaid records from 2008. We examined follow-up care for individuals with different levels of repeat withdrawal management. We found 32,196 Medicaid withdrawal management patients with a total of 67,073 episodes and we divided patients into low (1 episode, n = 19,602), medium (2-3 episodes, n = 8619) and high (≥4 episodes, n = 3978) use categories. High users had almost 8 times the withdrawal management cost of low users. Similarly, they had 5 times more emergency department visits than low users. High users had high levels of homelessness (75%), 20% had HIV/AIDS, and 40% had Hepatitis. High withdrawal management users were less likely than low users to receive any follow-up treatment services. Medicaid clients with high utilization of inpatient withdrawal management are a small but costly population with poor follow-up rates to subsequent treatment services. They are a socially disenfranchised group that may benefit from targeted services to address their complex clinical needs.
['Neighbors|Charles J|CJ|', 'Yerneni|Rajeev|R|', "O'Grady|Megan A|MA|", 'Sun|Yi|Y|', 'Morgenstern|Jonathan|J|']
D000328:Adult D000359:Aftercare D004636:Emergency Service, Hospital D005260:Female D015658:HIV Infections D006505:Hepatitis D006703:Homeless Persons D006801:Humans D007297:Inpatients D008297:Male D008484:Medicaid D008875:Middle Aged D009518:New York D012008:Recurrence D013375:Substance Withdrawal Syndrome D019966:Substance-Related Disorders D014481:United States D055815:Young Adult
Withdrawal management Cost Medicaid Service utilization High utilizers