title: Quality of care for substance use disorders in patients with serious mental illness.
abstract: We assessed the quality of care for substance use disorders (SUDs) among 8,083 patients diagnosed with serious mental illness from the VA mid-Atlantic region. Using data from the National Patient Care Database (2001-2002), we assessed the percentage of patients receiving a diagnosis of SUD, percentage beginning SUD treatment 14 days or earlier after diagnosis, and percentage receiving continued SUD care 30 days or less. Overall, 1,559 (19.3%) were diagnosed with an SUD. Of the 1,559, 966 (62.0%) initiated treatment and 847 (54.3%) received continued care. Although patients diagnosed with bipolar disorder were more likely to receive a diagnosis of SUD than those diagnosed with schizophrenia or schizoaffective disorder (22.7%, 18.9%, and 17.7%, respectively; chi(2) = 26.02, df = 2, p < .001), they were less likely to initiate (49.1%, 70.7%, and 68.6%, respectively; chi(2) = 59.29, df = 2, p < .001) or continue treatment (39.9%, 63.2%, and 62.2%, respectively; chi(2) = 72.25, df = 2, p <. 001). Greater efforts are needed to diagnose and treat SUDs in patients with serious mental illness, particularly for those with bipolar disorder.
authors.affiliation: VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA. amy.kilbourne@med.va.gov
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Ihsan
authors.initials: I
authors.lastname: Salloum
authors.forename: David
authors.initials: D
authors.lastname: Dausey
authors.forename: Jack R
authors.initials: JR
authors.lastname: Cornelius
authors.forename: Joseph
authors.initials: J
authors.lastname: Conigliaro
authors.forename: Xiangyan
authors.initials: X
authors.lastname: Xu
authors.forename: Harold Alan
authors.initials: HA
authors.lastname: Pincus
mesh_terms: D000328:Adult; D000368:Aged; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011787:Quality of Health Care / Q000592:standards*; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy*