When you think about it, it’s not the fact that’s surprising, but the extent. In 13 New Jersey hospitals, a third of all hospital costs were associated with behavioral health issues, such as substance abuse or mental illness. Even more alarming, the report by the Rutgers University Center for State Health Policy noted that three-fourths of the highest users of hospital services were afflicted with behavioral health conditions, compared to about a third of those who were not considered high users of services.
Lead author Sujoy Chakravarty says the large number affected by behavioral health problems surprised the researchers, too, and while they were specific to the 13 hospitals located in impoverished areas of New Jersey, he thinks the results would be fairly consistent with numbers in other like areas.
“I do not think it’s a stretch to believe that behavioral health can impact physical health and vice versa,” he says. “If you do not treat behavioral health in the community, it can hamper how well you manage physical health problems and lead to the hospital.” He pointed to an example of someone with diabetes and a substance abuse problem, who ends up in the hospital because that person is not capable of monitoring his or her blood sugar consistently or eating properly in an altered state or when all of the patient’s money is going to drugs.
In the hospital, too, they might be treated for both, but what happens back in the community may be fragmented. The emphasis may be on the addiction because that is what is having the most impact on the people around the patient, who may not have a primary care physician.
What this study points to is the need for integrating care and the potential benefits of accountable care organizations that truly connect the care both in and out of hospitals, Chakravarty says. “There is no concept of a behavioral health home like there is for a healthcare home,” he notes.
The report is part of a series that aims to find opportunities for improving care; others in the series can be found at www.cshp.rutgers.edu/content/medicaid-acos. It concludes that many hospitalizations among this group of people could be prevented with real coordinated care, if only they had access to it.
The entire report is available at http://www.cshp.rutgers.edu/Downloads/10530.pdf.
For more information on this topic, contact Sujoy Chakravarty, PhD, Assistant Research Professor, Rutgers University, New Brunswick, NJ. Email: [email protected].
