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General Hospital Inpatient Costs 



In order to estimate hospital costs associated with substance abuse, we have divided these costs 

 into four general categories: 



1) Direct treatment of substance abuse; 



2) Treatment of medical conditions totally attributable to substance abuse; 



3) Treatment of medical conditions where substance abuse is a major risk factor; and 



4) Treatment for medical conditions whose length of stay was extended due to 

 complications arising from a secondary diagnosis of substance abuse. 



We calculated the costs for each category by multiplying the number of hospital days attributable 



to substance abuse for the diseases and conditions in each category by an average inpatient 



hospital cost per day. To estimate the number of Medicaid substance abuse-related days in each 



category, we used hospital utilization data from the 1991 National Hospital Discharge Survey 



(NHDS) ' applying the following criteria: 



1) Direct Treatment - If the discharge had a primary diagnosis of either substance 

 dependence or substance-induced psychosis or poisoning, the hospital stay was assumed 

 to be for the direct treatment of the substance abuse problem. For these diagnoses, 

 100% of the hospital days were attributed to substance abuse. 



'The National Hospital Discharge Survey is conducted annually by the National Center for Health 

 Statistics. It is a national sample of more than 400 short-stay hospitals, producing over 200,000 

 discharges annually. The data are abstracted from the patients' medical records and include 

 demographic information, up to five diagnoses coded according to the International Classification of 

 Disease (ICD-9-CM), surgical procedures , length of stay, and expected source of payment. The sample 

 is weighted to derive national estimates of hospital utilization. 



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