title: Hospital utilization for injection drug use-related soft tissue infections in urban versus rural counties in California.
abstract: Drug related-soft tissue infections (DR-STIs) are a significant source of hospital utilization in inner-city urban areas where injection drug use is common but the magnitude of hospital utilization for DR-STIs outside of inner-city urban areas is not known. We described the magnitude and characteristics of hospital utilization for DR-STIs in urban versus rural counties in California. All discharges from all nonfederal hospitals in California in 2000 with ICD-9 codes for a soft tissue infection and for drug dependence/abuse were abstracted from the California Office of Statewide Health Planning and Development discharge database. There were 4,152 DR-STI discharges in 2000 from hospitals in 49 of California's 58 counties. Residents of 12 large metropolitan counties accounted for 3,598 discharges (87% of total). The majority of DR-STI discharges were from urban safety net hospitals with county indigent programs and Medicaid as the expected payment source and opiate related discharge diagnoses. Hospital utilization for DR-STIs in California is highest in large urban metropolitan counties, although DR-STI discharges are widespread. Increased access to harm reduction services and drug treatment may reduce government health care expenditures by preventing unnecessary hospital utilization for DR-STIs.
authors.affiliation: UCLA Department of Family Medicine, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA, 90025, USA. heinzk@ucla.edu
authors.forename: Keith G
authors.initials: KG
authors.lastname: Heinzerling
authors.forename: David A
authors.initials: DA
authors.lastname: Etzioni
authors.forename: Brian
authors.initials: B
authors.lastname: Hurley
authors.forename: Paul
authors.initials: P
authors.lastname: Holtom
authors.forename: Ricky N
authors.initials: RN
authors.lastname: Bluthenthal
authors.forename: Steven M
authors.initials: SM
authors.lastname: Asch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D002391:Catchment Area, Health; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D012423:Rural Health / Q000706:statistics & numerical data*; D017062:Small-Area Analysis; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014504:Urban Health / Q000706:statistics & numerical data*