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Emergency department utilization patterns for Medicare beneficiaries with serious mental disorders.

OBJECTIVE
This study examined emergency department use among Medicare beneficiaries with serious mental disorders.


METHODS
Drawn from the 2004 national 5% sample of Medicare beneficiaries, the sample in this study (N=129,805) included fee-for-service enrollees with primary diagnoses of schizophrenia, major depression, other major affective disorders, or other psychoses. Emergency department use was compared by psychiatric diagnostic category and presence of a claim related to substance use disorder.


RESULTS
Having any emergency department visit was common for beneficiaries aged >or=65 years (58.3%) and beneficiaries <65 years who were Medicare eligible because of a disability (48.5%). Emergency department visits with a primary psychiatric diagnosis occurred for 14.8% of disabled beneficiaries and 6.7% of aged beneficiaries. Use varied by diagnosis and was higher for those with any substance-related claims (p<.01).


CONCLUSIONS
Emergency department use was common in the sample. Within each eligibility category, use varied by psychiatric diagnostic category and presence of a substance-related claim.