Background. This article provides evidence about the relationship
between psychiatric disorders,
physical disorders and hospital use in the general medical sector using
a broadly based survey of the
US population.
Methods. The data are from the 1989 National Health Interview
Survey. This survey contains
medical and mental health evaluations for the entire sample. In a multivariate
framework, the
author estimates the effect of mental illness on the probability of being
admitted to a general
hospital, the number of admissions and the length of stay.
Results. Hospital use in the general medical sector is significantly
higher for persons with coexisting
physical and psychiatric conditions than for those with no psychiatric
disorders. For a wide range
of medical conditions, the predicted number of hospital admissions and
the length of a hospital stay
increase substantially when the physical illness is accompanied by a psychiatric
condition.
Conclusions. One implication of this finding is that economic
evaluations of alternative psychiatric
treatments should consider any differences in hospital costs related to
the treatment of coexisting
medical conditions. Another implication pertains to health care systems
where insurers have some
discretion over which individuals to insure. In the absence of adequate
adjustments in insurance
payments for high-risk potential enrollees, psychiatrically disabled persons
may have more limited
access to health insurance.