Table 2.
Patient-level factors associated with Elixhauser Comorbidity Index scores in 14,458 inpatient psychiatric admissions.3
| Variable | Total N (col %) (N=14458) | ECI ≥ 1 (row %) (N=10834) | Unadjusted OR (99% CI) | Adjusted OR (99% CI) |
|---|---|---|---|---|
| Age | ||||
| 18–24 | 2277 (15.8) | 57.5 | Reference | Reference |
| 25–34 | 3126 (21.6) | 63.1 | 1.26 (1.06–1.50) | 1.30 (1.09–1.55) |
| 35–44 | 2847 (19.7) | 76.5 | 2.40 (2.04–2.83) | 2.41 (2.01–2.88) |
| 45–54 | 3854 (26.7) | 84.8 | 4.12 (3.36–5.06) | 4.08 (3.29–5.06) |
| 55–64 | 2354 (16.3) | 89.4 | 6.21 (4.89–7.89) | 6.34 (4.91–8.19) |
| Gender | ||||
| Male | 7627 (52.8) | 69.3 | Reference | Reference |
| Female | 6831 (47.3) | 81.2 | 1.91 (1.71–2.14) | 1.66 (1.48–1.86) |
| Race/ethnicity | ||||
| Non-Hispanic White | 6118 (42.3) | 75.4 | Reference | Reference |
| Non-Hispanic Black | 4783 (33.1) | 74.0 | 0.93 (0.82–1.05) | 1.02 (0.89–1.17) |
| Puerto Rican-Hispanic | 1609 (11.1) | 77.1 | 1.10 (0.93–1.30) | 1.13 (0.94–1.36) |
| Other | 1248 (8.6) | 76.7 | 1.07 (0.89–1.29) | 1.11 (0.93–1.32) |
| Unknown | 700 (4.8) | 69.7 | 0.75 (0.59–0.96) | 0.88 (0.70–1.11) |
| Primary diagnosis at discharge | ||||
| Schizophrenia disorders | 5016 (34.7) | 70.7 | Reference | Reference |
| Schizoaffective disorders | 1887 (13.1) | 77.7 | 1.44 (1.22–1.70) | 1.47 (1.23–1.76) |
| Bipolar disorders | 3651 (25.3) | 75.1 | 1.25 (1.04–1.50) | 1.40 (1.15–1.70) |
| Depressive disorders | 2974 (20.6) | 80.4 | 1.70 (1.40–2.07) | 1.65 (1.37–2.00) |
| Other mental health disorders | 930 (6.4) | 73.7 | 1.16 (0.91–1.47) | 1.58 (1.25–2.01) |
| Co-occurring substance use diagnosis at discharge | ||||
| No | 7705 (53.3) | 75.6 | Reference | Reference |
| Yes | 6753 (46.7) | 74.2 | 0.93 (0.84–1.03) | 0.97 (0.87–1.08) |
| Length of stay | ||||
| 0–4 days | 2631 (18.2) | 75.6 | Reference | Reference |
| 5–14 days | 7575 (52.4) | 75.4 | 0.99 (0.85–1.14) | 0.91 (0.78–1.06) |
| 15–30 days | 3198 (22.1) | 74.7 | 0.95 (0.80–1.13) | 0.83 (0.67–1.02) |
| 31–60 days | 1054 (7.3) | 70.8 | 0.78 (0.64–0.95) | 0.67 (0.52–0.87) |
| Homeless at admission | ||||
| No | 12378 (85.6) | 74.7 | Reference | Reference |
| Yes | 1302 (9.0) | 75.2 | 1.03 (0.85–1.24) | 1.08 (0.90–1.28) |
| Prior engagement in psychiatric outpatient services | ||||
| Active (past month) | 7162 (49.5) | 77.3 | Reference | Reference |
| Recent (past 12 months, but not past month) | 3248 (22.5) | 74.4 | 0.85 (0.74–0.99) | 0.86 (0.74–1.00) |
| None (none in past 12 months) | 4048 (28.0) | 71.3 | 0.73 (0.63–0.85) | 0.70 (0.60–0.82) |
Sources: (1) Medicaid claims records and clinician data; (2) the 2012–2013 American Hospital Association Annual Survey; (3) the 2012–2013 Health Resources and Human Services Administration Area Resource File; and (4) a 2012–2013 New York State (NYS) Managed Behavioral Healthcare Organizations (MBHOs) Discharge File created during a statewide quality assurance program in which NYS contracted with five MBHOs in geographically distinct regions to review fee-for-service inpatient psychiatric admissions. Data includes patients ages 18–64 admitted to an inpatient psychiatric unit during 2012–2013 with a principal diagnosis of any mental disorder; Elixhauser Comorbidity Index (ECI) scores based on clinical diagnoses during the 12 months prior to each unique individual’s initial inpatient admission.