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VOLUME 53 | NUMBER 3 | JUNE 2018


Massachusetts Health Reform's Effect on Hospitalizations with Substance Use DisorderRelated Diagnoses

Objective: To examine whether Massachusetts (MA) health reform affected substance (alcohol or drug) use disorder (SUD)–related hospitalizations in acute care hospitals.

Data/Study Setting: 2004–2010 MA inpatient discharge data.

Design: Differenceindifferences analysis to identify pre to postreform changes in age and sexstandardized populationbased rates of SUDrelated medical and surgical hospitalizations, adjusting for secular trends.

Data Extraction Methods: We identified 373,751 discharges where a SUDrelated diagnosis was a primary or secondary discharge diagnosis.

Findings: Adjusted for age and sex, the rates of drug use–related and alcohol use–related hospitalizations prereform were 7.21 and 8.87 (per 1,000 population), respectively, in highuninsurance counties, and 8.58 and 9.63, respectively, in lowuninsurance counties. Both SUDrelated rates increased after health reform in high and lowuninsurance counties. Adjusting for secular trends in the high and lowuninsurance counties, health reform was associated with no change in drug or alcoholrelated hospitalizations.

Conclusions: Massachusetts health reform was not associated with any changes in substance use disorder–related hospitalizations. Further research is needed to determine how to reduce substance use disorder–related hospitalizations, beyond expanding insurance coverage.

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