Analysis of U.S. trends in discharges from general hospitals for episodes of serious mental illness, 1995-2002

Objective: The aim of this study was to ascertain trends from 1995 to 2002 in general hospital discharges among adults in the United States with serious mental illness. Methods: As of 2002 the National Hospital Discharge Survey collected data on approximately 327,000 discharges from 445 hospitals. ICD-9-CM codes were used to identify the discharges between 1995 and 2002 associated with serious mental illness. Results: Annual discharge rates involving serious mental illness increased by 34.7%, from 29.1 discharges per 10,000 in the U. S. adult population ( 18 years and older) in 1995 to 39.2 discharges per 10,000 in the U. S. adult population in 2002. Hospital discharges involving serious mental illness increased significantly in the black population and among young adults. For adults of ages 18 to 24, discharges per 10,000 increased from 19.9 in 1995 to 42.3 in 2002. A substantial increasing trend was seen for the Northeast and South census regions. There was an increase in the proportion of discharges associated with hospitalizations for serious mental illness that were covered by private payers, whereas there was a significant decline in such discharges when patients were covered by government programs. Conclusions: The increasing trend in general hospital discharges involving serious mental illness has continued into recent years. Further investigations are needed to understand how patient- and system-level factors have contributed to the increasing trend in general hospital discharges involving an episode of serious mental illness.