Prevalence and correlates of past-year acute behavioral healthcare utilization: Results from the 2008 National Survey on Drug Use and Health

Objective: Examine the prevalence and correlates of past-year acute behavioral healthcare utilization (i.e., care delivered in inpatient/residential or hospital/emergency room settings). Methods: Data were derived from the 2008 National Survey on Drug Use and Health (n = 10,069 adults with behavioral health disorders). Associations between past-year acute care use and factors related to healthcare use were examined through bivariate and logistic regression analyses. The logistic regression model examined the relationship between acute behavioral healthcare utilization and theoretically relevant variables per Anderson's Behavioral Model of Healthcare Utilization. Results: Five percent of those with a behavioral health disorder utilized acute behavioral healthcare services in the past year. Several variables were significantly associated with acute care use in the final logistic regression model (R2 = .179, p < .0001), including those with a lifetime history of substance abuse treatment (OR = 4.91) and those with a severe mental illness in the past year (OR = 2.50). Individuals with only one type of behavioral health disorder were most likely to receive services targeting only that area of need. However, those with co-occurring disorders were most likely to receive acute care for only their substance abuse treatment needs. Conclusions: The elevated prevalence of acute care for substance abuse treatment needs among those with co-occurring disorders observed in this study may be the result of barriers to and reduced availability of outpatient care for substance abuse needs. Targeted policies and interventions are necessary to improve outpatient behavioral healthcare to reduce the utilization of acute healthcare services.