Key Takeaways:
- Mental health and substance use conditions were found to be more prevalent among inpatient than emergency department (ED) encounters.
- Depression and anxiety disorders were found to be the most prevalent mental health diagnoses among both inpatient and ED encounters.
- Using both the primary and secondary diagnoses results in a greater prevalence of mental health and substance use disorders.
Introduction
Behavioral health includes mental health, like anxiety and bipolar depression, and substance use issues, like alcohol or drug disorders. How often do these conditions appear in California hospital visits? To answer that question, we analyzed inpatient and emergency department encounters for a full year.
Behavioral Health Conditions Among Inpatient Encounters
The results of categorizing all 2022 inpatient encounters into the CHIA behavioral health categories using both primary and secondary diagnoses are shown below (N =3,119,179).
Across all inpatient encounters, a third (33%) had a Mental Health, Substance Use, or a Co-Occurring Disorder on their record (n = 1,036,633).
- Eighteen percent had only a Mental Health Disorder (n = 553,291), with the most common being Mood Disorders (i.e., depression) and Anxiety Disorders.
- Eight percent had only a Substance Use Disorder (n = 248,696), with the most common being Alcohol Disorders.
- Seven percent had both (n = 234,646), with the most common combination being Mood Disorders and Alcohol Disorders.
- Based on using only the primary diagnosis to categorize the inpatient encounters into the behavioral health categories, 6% had a Mental Health Disorder (n = 184,826) and 1% had a Substance Use Disorder (n = 44,704) as their primary diagnosis.
Behavioral Health Conditions Among Emergency Department Encounters
Below is the behavioral health category breakdown for emergency department encounters, using both primary and secondary diagnoses, for 2022 (N = 11,506,812). It appears that behavioral health diagnoses are less common in the emergency department (12%) than for inpatient (33%) encounters.
Across all emergency department encounters, 12% had a Mental Health, Substance Use, or Co-Occurring Disorder on their record (n = 1,373,601).
- Seven percent had only a Mental Health Disorder (n = 467,269), with the most common being Anxiety Disorders and Mood Disorders (i.e., depression).
- Four percent had only a Substance Use Disorder (n = 164,822), with the most common being Alcohol Disorders, followed by Cannabis Disorders.
- One percent had co-occurring conditions (n = 164,822), with the most common combination being Schizophrenia paired with Stimulant Disorders.
- Based on using only the primary diagnosis to categorize the emergency department encounters into the behavioral health categories, 3% had only a Mental Health Disorder (n = 313,761) and 2% had only a Substance Use Disorder (n = 213,938) as their primary diagnosis.
Conclusion
Behavioral Health Conditions are present in a significant number of hospital encounters, usually as a secondary diagnosis. The following are key takeaways from this analysis.
- Mental Health and Substance Use conditions were found to be more prevalent among inpatient (33%) than emergency department (12%) encounters.
- Mood Disorders, such as depression and anxiety disorders, were found to be the most prevalent mental health diagnoses and Alcohol Disorders were found to be the most common Substance Use diagnoses among both inpatient and emergency department encounters.
- Using both the primary and secondary diagnoses results in a greater prevalence of both Mental Health and Substance Use Disorders, as opposed to only using the primary diagnosis.
