Variations in Utilization and Cost of Inpatient Psychiatric Services Among Adults in Maryland

The author examined variations in the clinical characteristics, costs, utilization, and discharge patterns of adult inpatients who were hospitalized for psychiatric disorders in Maryland state general hospitals in 1998. Administrative discharge data on all 30,121 adult psychiatric patients in the state in 1998 were used to calculate descriptive statistics on elderly (age 65 years and over) and nonelderly (age 19 to 64 years) patients. The most common reasons for hospitalization were substance-related disorders, which affected 25 percent of the patients, and major depressive disorders, which affected 24.6 percent of the patients. After the effects of Medicare's prospective payment system were disregarded, the average cost of treating elderly persons for depression was calculated to be around 80 percent higher than national estimates.