Epidemiology of hospitalizations with cocaine use disorder: A 17-year U.S. national study.

Objective: To examine the time-trends in hospitalizations and the factors associated with outcomes of hospitalizations with cocaine use disorder (CocUD).

Methods: This study used the U.S. National Inpatient Sample (NIS) data from 1998 to 2014 to examine the time-trends in hospitalization rates and the predictors of healthcare utilization (total hospital charges, discharge destination, length of hospital stay) and in-hospital mortality for CocUD-hospitalization. We used multivariable-adjusted logistic regression analyses to assess the association of patient demographics (age, sex, race/ethnicity, household income), comorbidity (Deyo-Charlson index), insurance payer (Medicare, Medicaid, private, self-pay or other), and hospital characteristics (location/teaching status; hospital bed size; and region) with outcomes with healthcare utilization and in-hospital mortality for CocUD-hospitalizations.

Results: There were 6,454,775 weighted hospitalizations with CocUD in the U.S. 1998-2014. The population was predominantly black (38%), 45 years or younger (65%) and male (63%). There was no change from study periods, 1998-2000 to 2013-2014, in the hospitalization rate, 959 to 973 per 100,000 NIS claims or in-hospital mortality rate, 7.7 to 9.2, respectively. In the multivariable-adjusted analyses, we found that older age, male gender, non-white race, Deyo-Charlson index score of 2 or higher, insurance payer other than private, higher income, hospital region, an urban setting hospital and a larger hospital bed size were associated with higher healthcare utilization outcomes and/or in-hospital mortality.

Conclusions: The hospitalization and in-hospital mortality of hospitalizations with CocUD remained stable over the study period from 1998 to 2014. This study identified several factors associated with healthcare utilization outcomes and mortality outcomes of hospitalizations with CocUD.