S3001 The Impact of Mental Health Disorders on Resource Utilization Among Intestinal Obstruction Hospitalizations

Introduction: Mental health disorders are linked to a higher risk of adverse clinical outcomes in individuals with physical illnesses. While mental health alone may not significantly impact outcomes in bowel obstruction cases, its interaction with factors such as race and insurance status has been associated with worse outcomes. This study investigates the impact of mental health disorders on resource utilization among adult patients hospitalized for intestinal obstruction (IO) in Texas. Methods: We used de-identified and statewide data to conduct a population-based cohort study of non-elective admissions of Texas residents aged 18 years or older with a principal diagnosis of IO admitted to acute care hospitals from 2016 to 2023. Hospitalizations transferred to or from another hospital were excluded. IO was identified using ICD-10 codes selected from Clinical Classification Software Refined Category DIG012: Intestinal obstruction and ileus. The exposure was mental health disorders (MHD) identified using ICD-10 codes from CCSR Chapter MBD: Mental, behavioral, and neurodevelopmental disorders.We applied propensity score overlap weighting. Sensitivity analyses included types of MHD. Results are reported as adjusted risk difference and 95% confidence interval (aRD [95% CI]). Results: Of 123,733 hospitalizations, 31,166 (25.2%) had a psychiatric illness. Patients with MHD were more often women (63.1% vs 50.7%) and had a higher comorbidity index (mean [standard deviation] 1.65[2.08] vs 1.10[1.96]). Mood disorders (13.6%) and anxiety disorders (13.5%) were the most common diagnoses. Patients with a MHD had longer length of stay (5.7[6.1] days vs 4.7[5.6] days) and higher total charges ($81,236 [$108,935] vs $68,222 [$94,203]). After overlap weighting, length of stay aRD 0.57 days (95% CI 0.48 to 0.65) and total charges aRD ($6,365 [$4,848 to $7,881]) remained associated with MHD. Anxiety disorders had the largest impact on resource utilization, as evidenced by a relative risk (aRD) of 0.86 (95% CI 0.04 to 1.68) and total charges (aRD) of $7,585 (95% CI $5,769 to $9,401). Conclusion: Among hospitalized patients with intestinal obstruction, those with mental health disorders were associated with longer hospital stays, higher resource utilization, and hospital charges. These highlight the importance of an integrated approach to address the psychiatric and medical needs of patients for better outcomes and reducing healthcare burden.