SBIRT administered by mental health counselors for hospitalized adults with substance misuse or disordered use: Evaluating hospital utilization and costs

McCall, Marcia H.; Wester, Kelly L.; Bray, Jeremy; Hanchate, Amresh; Veach, Laura J.; Smart, Benjamin D.; Morris, Carrie A. Wachter

doi:10.1016/j.jsat.2021.108510

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…For patients with alcohol misuse or disordered use, SBIRT (Screening, Brief Intervention, and Referral to Treatment) interventions were associated with a significant reduction in subsequent hospitalization and emergency department visit likelihood [61]. The results did not show significant cost reductions for patients using illicit or prescription drugs, or those using both alcohol and drugs.…”

Section: Strategies For Efficiently Managing Patients and Optimizing ...mentioning

confidence: 87%

Hospitalization Costs and Mental Health: Challenges and Solutions from Recent Research - A Narrative Review

Tibirna,

Petrescu,

Ciobanu

et al. 2024

Preprint

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Mental disorders impact a significant portion of the global population, presenting substantial challenges to healthcare systems due to high hospitalization costs and resource demands. This narrative review explores the economic implications of mental health disorders, focusing on hospitalization costs, the effectiveness of interventions, and the outcomes of recent research. Materials and Methods: A narrative review was conducted, sourcing articles from PubMed and Google Scholar published between 2014 and 2024. The search terms included combinations related to mental illness, costs, hospital care, and mental healthcare interventions. A total of 1,110 articles were initially identified, with 37 studies meeting the inclusion criteria after rigorous screening by two independent researchers. These studies included quantitative and qualitative data covering a range of outcomes such as hospital admission rates, consumer satisfaction, and quality of life. The findings of the present review reveal that mental disorders significantly increase hospitalization costs due to frequent admissions, extended stays, and the need for specialized treatments. Additionally, physical comorbidities in individuals with mental disorders lead to higher healthcare costs and resource use. Integrated care models, early intervention, and preventive strategies show promise in reducing these costs and improving patient outcomes. Conclusions: Our review emphasizes the critical need for integrated healthcare strategies that address both mental and physical health to reduce hospitalization costs and improve outcomes. Effective management of mental health disorders requires comprehensive approaches, including complex outpatient services and preventive care. Future research should focus on standardizing methodologies to provide clearer insights into the economic impact of mental health conditions and guide effective healthcare strategies.

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Section: Strategies For Efficiently Managing Patients and Optimizing ...mentioning

confidence: 87%

Hospitalization Costs and Mental Health: Challenges and Solutions from Recent Research - A Narrative Review

Tibirna,

Petrescu,

Ciobanu

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“… 18 , 34 SBIRT is also cost effective, with one study showing that $2547 USD per patient is saved with SBIRT administration. 35 To our knowledge, this is the first study that investigates the impact of SBIRT, specifically for AAH and DARLC patients. The cost-effectiveness and accessibility of SBIRT make it a valuable asset in reducing readmissions for AAH patients.…”

Section: Discussionmentioning

confidence: 99%

Inpatient Screening, Brief Intervention, and Referral to Treatment for Alcohol Use Disorder in Patients Admitted with Alcohol-associated Liver Disease Is Not Universally Implemented in Practice, But Can Reduce Readmissions for Alcohol-associated Hepatitis

Wang,

Puglia

2023

Journal of the Canadian Association of Gastroenterology

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Introduction The management of alcohol-related liver disease requires a multidisciplinary approach to treat alcohol use disorder. We aimed to determine the proportion of actively drinking patients admitted for alcohol-associated hepatitis (AAH) or decompensated alcohol-related cirrhosis (DARLC) who were offered or underwent screening, brief intervention, and referral to treatment (SBIRT) for alcohol use disorder during admission and if inpatient SBIRT is associated with reduced readmissions for alcohol-related liver disease. Methods We conducted a retrospective cohort study of actively drinking patients admitted to our institution from January 2017 to December 2021 with AAH or DARLC. Logistic regression was used to identify factors, such as conducting SBIRT, that were associated with 30-day and 90-day readmissions for recurrent AAH or DARLC. Results There were 120 AAH admissions (mean age 47.7 ± 13.6 years), and 177 DARLC admissions (mean age 58.2 ± 9.5 years). SBIRT was conducted in only 51.7% of AAH admissions, and 23.7% of DARLC admissions. For AAH, conducting SBIRT was associated with significantly reduced 30-day (OR 0.098, P = 0.001, 95% CI 0.024–0.408) and 90-day (OR 0.166, P = 0.003, 95% CI 0.052–0.534) readmissions. For DARLC, there was no association between conducting SBIRT and 30-day or 90-day readmissions. Conclusion SBIRT was conducted with actively drinking patients in only 51.7% of AAH admissions and 23.7% of DARLC admissions. Patients admitted for AAH who received inpatient SBIRT had decreased 30-day and 90-day readmission rates for AAH or DARLC.

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“…Additionally, using a team-based approach and including other PED/UC staff (e.g., social worker) into tobacco efforts would expand available PED/UC-based resources. For example, prior research indicates that mental health counselors can be effective in providing brief interventions for substance use disorders [ 59 ], and a computerized tobacco program promoted treatment initiation [ 60 ]. Therefore, a multi-disciplinary team-based approach should be considered for delivery of future interventions.…”

Section: Discussionmentioning

confidence: 99%

Barriers to implementation of pediatric emergency department interventions for parental tobacco use and dependence: a qualitative study using the theoretical domains framework

Merianos

Fiser

Mahabee‐Gittens

et al. 2022

Implement Sci Commun

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Background Pediatric emergency department (PED) and urgent care (UC) professionals can play a key role in delivering evidence-based guidelines to address parental tobacco use and child tobacco smoke exposure (TSE). Understanding PED/UC professionals’ perceptions regarding these guidelines is the first step in developing and implementing a TSE screening and counseling intervention in these settings. This study aimed to use the theoretical domains framework (TDF) to identify current screening and counseling behaviors of PED/UC professionals related to parental tobacco use and child TSE, and determine barriers and enablers that influence these behaviors. Methods Semi-structured, focused interviews were conducted with 29 actively practicing PED/UC clinical staff who worked at one large, Midwestern children’s hospital. The interview guide was informed by the TDF and included open-ended questions. Content analysis of interview transcripts was guided by the TDF. Nurses, physicians, and healthcare administrators were assessed overall and by group membership to ensure each group was represented based on their varying PED/UC roles. Results Fifty-one percent were nurses, 38% were physicians, and 11% were healthcare administrators. Most PED/UC professionals did not currently follow the guidelines, but perceived addressing parental tobacco use as part of their role. All 14 TDF domains were identified by nurses, physicians, and administrators in relation to counseling for parental tobacco use and child TSE. Domains with the most sub-themes were (1) knowledge: lack of knowledge about tobacco counseling, including implementing counseling, cessation resources/referrals, and thirdhand smoke; (2) beliefs about capabilities: not comfortable counseling parents, easier to discuss with parents who are receptive and to ask and advise when patients have a TSE-related complaint, and more likely to discuss if there were resources/referrals; and (3) environmental context and resources: barriers include lack of time, training, and resources and referral information to give to parents, and an enabler is using TSE-related complaints as a context to offer counseling. Conclusions Study findings provide a strong foundation for developing and implementing clinical practice guidelines regarding parental tobacco use and child TSE in the PED/UC setting. Future intervention development will address all TDF domains and test the implementation of the intervention in the PED/UC setting.

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SBIRT administered by mental health counselors for hospitalized adults with substance misuse or disordered use: Evaluating hospital utilization and costs

Cited by 5 publications

References 30 publications

Hospitalization Costs and Mental Health: Challenges and Solutions from Recent Research - A Narrative Review

Hospitalization Costs and Mental Health: Challenges and Solutions from Recent Research - A Narrative Review

Inpatient Screening, Brief Intervention, and Referral to Treatment for Alcohol Use Disorder in Patients Admitted with Alcohol-associated Liver Disease Is Not Universally Implemented in Practice, But Can Reduce Readmissions for Alcohol-associated Hepatitis

Barriers to implementation of pediatric emergency department interventions for parental tobacco use and dependence: a qualitative study using the theoretical domains framework

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