Volume 53 | Number 3 | June 2018

Abstract List

Karen E. Lasser M.D., M.P.H., Amresh D. Hanchate Ph.D., Danny McCormick M.D., M.P.H., Alexander Y. Walley M.D., M.Sc., Richard Saitz M.D., M.P.H., Meng‐Yun Lin M.P.H., Nancy R. Kressin Ph.D.


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

Data/Study Setting

2004–2010 inpatient discharge data.


Difference‐in‐differences analysis to identify pre‐ to postreform changes in age‐ and sex‐standardized population‐based rates of ‐related medical and surgical hospitalizations, adjusting for secular trends.

Data Extraction Methods

We identified 373,751 discharges where a ‐related diagnosis was a primary or secondary discharge diagnosis.


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 high‐uninsurance counties, and 8.58 and 9.63, respectively, in low‐uninsurance counties. Both ‐related rates increased after health reform in high‐ and low‐uninsurance counties. Adjusting for secular trends in the high‐ and low‐uninsurance counties, health reform was associated with no change in drug‐ or alcohol‐related hospitalizations.


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.