Research Alert: May 15, 2023

New Research on Inpatient Hospital Stays for Substance Use Disorder

Factors Associated With Lengths-of-Stay for Inpatients With Substance Use Disorders

This policy brief identifies factors associated with inpatient lengths-of-stay (LOS) for the treatment of substance use disorders (SUDs) and whether there are systematic differences in LOS for rural and urban residents.

Key Findings:

• Inpatient LOS for SUD treatment were longer for rural residents using urban hospitals than rural residents using rural hospitals.
• LOS were longer for patients who resided in mental health professional shortage areas and in areas with fewer buprenorphine waivered physicians.
• Medicare patients had longer hospital stays than similar patients without Medicare when holding other factors constant, including patient age, and the presence of other SUD, mental, and chronic conditions.

Rural and Urban Differences in Factors Associated With Inpatient Hospital Stays for Substance Use Disorder

This brief uses 2018 all-payer claims data from seven states to describe the lengths and costs of inpatient hospital stays for SUDs and examines whether there were differences between stays for rural and urban residents.

Key Findings:

• Medicare and Medicaid were the primary payers for a higher proportion of rural inpatients, while urban inpatients were more likely to have private insurance coverage for inpatient hospital stays.
• The percentage of inpatient stays for primary SUD diagnosis admitted through court or law enforcement channels was four and a half times higher for rural residents than for urban residents.
• The proportion of rural inpatients who resided in areas with no access to buprenorphine waivered physicians was more than nine times higher than for urban inpatients.

Additional Resources of Interest:

• More information about the Rural Health Equity Research Center
• More information from the Rural Health Information Hub's topic guide: Substance Use and Misuse