Background: Hospital discharges due to psychotropics poisoning whether intentional, unintentional, prescription errors or related side effects have been increasing nationally. Hospital costs are also increasing subsequently. We compared the annual rate of hospital discharges in 4 regions of United States (West, Midwest, South, and Northeast) while incorporating the number of the mental health providers in these regions to see if there is an association between the number of mental health providers and the number of psychotropic poisoning hospital discharges.
Methods: This is a retrospective study utilizing Healthcare Cost and Utilization Project (HCUP) from 1997 through 2014. Discharges due to psychotropic agents from 1997 to 2014 were identified by using ICD-9 sorted by Clinical Classification Software. The annual rate of discharges in 4 regions of the United States: West, Midwest, Northeast, and South, were obtained and compared. America’s Health Rankings 2017 annual report used to correlate the distribution of mental health providers (psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, providers that treat alcohol and other drug abuse and advanced practice nurses specializing in mental health care) with the rate of discharges. Analysis Of Variance (ANOVA) used to detect statistical significance.
Results: A sample of 1,368,649 discharges from the four regions was compared. The mean of the annual rates of hospital discharges due to psychotropics poisoning from 1997 through 2014 was calculated in each region: West 21.06, Northeast 23.6, South 27.3 and Midwest 28.6 per 100,000 persons.ANOVA test used to compare the annual rate of discharge for each region from 1997 through 2014, demonstrated a significant statistical difference with P-value of <0.00001 and F-value of 22. America’s Health Ranking in 2017 reports the highest number of mental health providers per capita in the West then the Northeast and lowest in the South.
Conclusions: Our study revealed a difference between the rate of hospital discharges due to psychotropics poisoning in 4 different regions in the US, the lowest rate in the West and higher in the Midwest. A higher number of hospital discharges are in the regions of the United States where there are less mental health providers. Increasing mental health providers in the south and Midwest would likely lead to a decrease in hospital discharges rate from psychotropic medication poisoning. This could likely be due to closer patient follow up as well as tighter medication regulation. Further prospective studies are warranted to conclude this association.
