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Hospitalization Pattern, Inpatient Service Utilization and Quality of Care in Patients With Alcohol Use Disorder: A Sequence Analysis of Discharge Medical Records
Alcohol and Alcoholism ( IF 2.8 ) Pub Date : 2019-12-17 , DOI: 10.1093/alcalc/agz081 Xueyan Han 1 , Feng Jiang 1 , Huixuan Zhou 1 , Jack Needleman 2 , Moning Guo 3 , Yin Chen 4 , Yuanli Liu 1 , Yilang Tang 5, 6
更新日期：2020-04-17
Alcohol and Alcoholism ( IF 2.8 ) Pub Date : 2019-12-17 , DOI: 10.1093/alcalc/agz081 Xueyan Han 1 , Feng Jiang 1 , Huixuan Zhou 1 , Jack Needleman 2 , Moning Guo 3 , Yin Chen 4 , Yuanli Liu 1 , Yilang Tang 5, 6
Affiliation
Aims
To identify and group hospitalization trajectory of alcohol use disorder (AUD) patients and its associations with service utilization, healthcare quality and hospital-level variations.Methods
Inpatients with AUD as the primary diagnosis from 2012 to 2014 in Beijing, China, were identified. Their discharge medical records were extracted and analyzed using the sequence analysis and the cluster analysis.Results
Eight-hundred thirty-one patients were included, and their hospitalization patterns were grouped into four clusters: short stay (n = 565 (67.99%)), mean psychiatric length of stay in 3 years: (32.25 ± 18.69), repeated short stay (n = 211 (25.39%), 137.76 ± 88.8 days), repeated long stay (n = 41 (4.93%), 405.44 ± 146.54 days), permanent stay (n = 14 (1.68%), 818.14 ± 225.22 days). The latter two clusters (6.61% patients) used 37.26% of the total psychiatric hospital days and 33.65% of the total psychiatric hospitalization expenses. All the patients in the permanent stay cluster and 41.77% of the patients in the short stay cluster were readmitted at least once within 3 years. Two-hundred thirty-four patients (28.16%) were admitted at least once for non-psychiatric reasons, primarily for diseases of circulatory and digestive systems. Cluster composition varied significantly among different hospitals.Conclusion
Hospitalization pattern of patients with AUD varies greatly, and while most (>2/3) hospitalizations were short stay, those with repeated long stay and permanent stay used more than one third of the hospital days and expenses. Our findings suggest interventions targeting at certain patients may be more effective in reducing resource utilization.
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