Indicator Description
Studies have found that hospitalizations are frequently associated with complications for alcohol and drug use. Because the level of harm is related to the level and pattern of substance use in a community, hospital cases are also an indirect indicator of substance use in a community. These data illustrate the high percentage of medical costs associated with alcohol, tobacco, and drugs.

What to Measure

• Percent of hospital discharges associated with a primary or secondary diagnosis related to substance use.
• Substance use-related discharge rate per 100,000 population.
• Number of cases for specific types of disorders (addiction treatment versus injury or disease, for example) or for particular age or ethnic population groups.

There are four main indicator measures:

1. Alcohol-related cases: The number of hospital discharges for the treatment of alcohol addiction and for diseases and injuries directly and/or indirectly attributable to alcohol use.
2. Drug-related cases: The number of hospital discharges for the treatment of drug addiction and for diseases and injuries directly and/or indirectly attributable to drug use.
3. Tobacco-related cases: The number of hospital discharges related to diseases associated with tobacco use.
4. Substance use-related problems of newborns: The number of hospital discharges for newborns with one or more of the following diagnoses: fetal alcohol syndrome; fetal drug-induced disorder; newborn drug withdrawal syndrome; or another alcohol or drug problem diagnosis.

Where to Find Local Data

• Drug Abuse Warning Network (DAWN): DAWN is a public health surveillance system that monitors drug-related visits to hospital emergency departments and drug-related deaths investigated by medical examiners and coroners.
• Local hospitals.
• State health department.
• State hospital association.
• Medicaid program.

Interpretation Guidelines

• When identifying hospital cases, some hospital discharges will have diagnoses related to more than one substance. You should be careful to count those cases only once, or to note how many hospital cases are counted under two or three measures.
• The total number of hospital cases may vary over time and across communities depending upon differences and changes in the health care system. Therefore, using the percent of discharges, rather than some other rate, has some advantages.

Resources

Drug-Related ICD-9-CM Diagnoses and Diagnostic Related Groups. National Institute on Drug Abuse. Assessing Drug Abuse Within and Across Communities, In press. Rockville, MD: The Institute, 2005.

New Mexico Department of Health. Drug Abuse Patterns and Trends in New Mexico: September 2004 Proceedings of the New Mexico State Epidemiology Workgroup, January 2005.