title: Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders.
abstract: OBJECTIVE
  We aim to examine the relationships between substance use disorders and preventable hospitalizations for Ambulatory Care Sensitive Conditions among adult Medicaid beneficiaries.
  
  
  METHODS
  Cross-sectional analysis using de-identified Medicaid claims data in 2012 from 177,568 beneficiaries in Missouri was conducted. Logistic regression models were estimated for the associations of substance use disorder status with Ambulatory Care Sensitive Conditions, demographics, chronic physical and mental illnesses. Zero-inflated negative binomial regressions assessed substance use disorders, hospitalization for Ambulatory Care Sensitive Conditions, and length of hospital stay for Ambulatory Care Sensitive Conditions adjusting for co-morbid physical illnesses, mental illnesses and demographics.
  
  
  RESULTS
  Over 12% of the sample had been diagnosed for substance use disorder. Beneficiaries with substance use disorder were more likely than Nonsubstance use disorder beneficiaries to have admissions for chronic conditions including short/long-term complications of diabetes, uncontrolled diabetes, hypertension, chronic obstructive pulmonary disease/asthma, but not for acute conditions. While substance use disorder beneficiaries were more likely than Nonsubstance use disorder beneficiaries to be hospitalized for any Ambulatory Care Sensitive Conditions; there were no statistical differences between the two groups in terms of length of hospital stays.
  
  
  CONCLUSIONS
  Substance use disorder is statistically associated with hospitalizations for most Ambulatory Care Sensitive Conditions but not with length of hospital stay for Ambulatory Care Sensitive Conditions, after adjusting for covariates. The significant associations between substance use disorder and Ambulatory Care Sensitive Condition admissions suggest unmet primary health care needs for substance use disorder beneficiaries and a need for integrated primary/behavioral healthcare.
authors: MIMH,University of Missouri - St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134-3115, USA.
authors: Kit Sang
authors: KS
authors: Leung
authors: MIMH,University of Missouri - St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134-3115, USA; Missouri Department of Social Services, 615 Howerton Court, PO Box 6500, Jefferson City, MO 65102-6500, USA.
authors: Joe
authors: J
authors: Parks
authors: MIMH,University of Missouri - St. Louis, 4633 World Parkway Circle, St. Louis, MO 63134-3115, USA.
authors: James
authors: J
authors: Topolski
keywords: ACSC; Addiction; Ambulatory Care Sensitive Condition; Avoidable hospitalization; Medicaid; Preventable hospitalization; Substance abuse; Substance use disorders