PSYCHIATRIC-HOSPITAL OUTCOMES OF DUAL DIAGNOSIS PATIENTS UNDER MANAGED CARE

The authors compared patterns of psychiatric hospitalization utilizati on and outcomes between persons with and without co-existing substance -related disorders in a managed care environment by means of a prospec tive follow-along study of persons hospitalized for psychiatric reason s under the auspices of a large regional managed care firm. Forty-two psychiatric inpatients with comorbid substance disorders and 121 inpat ients without coexisting substance disorders were compared across meas ures of service use and psychiatric acuity. Readmission to the hospita l was assessed at 30 days and after 6 months. Patients with coexisting substance disorders spent fewer days in the hospital but were rehospi talized at a higher rate both within 30 days and (significantly) after 6 months. These results suggest that the revolving-door pattern of se rvice utilization is also present in managed care environments.