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Matern Child Health J. 2015 Oct;19(10):2168-78. doi: 10.1007/s10995-015-1730-1.

Refining Measurement of Substance Use Disorders Among Women of Child-Bearing Age Using Hospital Records: The Development of the Explicit-Mention Substance Abuse Need for Treatment in Women (EMSANT-W) Algorithm.

Author information

1
Education Division, Center for Education and Human Services, SRI International, 333 Ravenswood Avenue, BS179, Menlo Park, CA, 94025, USA. taletha.derrington@sri.com.
2
Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA. taletha.derrington@sri.com.
3
Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
4
Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
5
Bureau of Substance Abuse Services, Massachusetts Department of Public Health, Boston, MA, USA.
6
Office of Data Translation, Bureau of Family Health and Nutrition, Massachusetts Department of Public Health, Boston, MA, USA.
7
MassGeneral Hospital for Children, Harvard Medical School, Boston, MA, USA.

Abstract

Substance use disorder (SUD) in women of reproductive age is associated with adverse health consequences for both women and their offspring. US states need a feasible population-based, case-identification tool to generate better approximations of SUD prevalence, treatment use, and treatment outcomes among women. This article presents the development of the Explicit Mention Substance Abuse Need for Treatment in Women (EMSANT-W), a gender-tailored tool based upon existing International Classification of Diseases, 9th Edition, Clinical Modification diagnostic code-based groupers that can be applied to hospital administrative data. Gender-tailoring entailed the addition of codes related to infants, pregnancy, and prescription drug abuse, as well as the creation of inclusion/exclusion rules based on other conditions present in the diagnostic record. Among 1,728,027 women and associated infants who accessed hospital care from January 1, 2002 to December 31, 2008 in Massachusetts, EMSANT-W identified 103,059 women with probable SUD. EMSANT-W identified 4,116 women who were not identified by the widely used Clinical Classifications Software for Mental Health and Substance Abuse (CCS-MHSA) and did not capture 853 women identified by CCS-MHSA. Content and approach innovations in EMSANT-W address potential limitations of the Clinical Classifications Software, and create a methodologically sound, gender-tailored and feasible population-based tool for identifying women of reproductive age in need of further evaluation for SUD treatment. Rapid changes in health care service infrastructure, delivery systems and policies require tools such as the EMSANT-W that provide more precise identification methods for sub-populations and can serve as the foundation for analyses of treatment use and outcomes.

KEYWORDS:

Diagnosis code grouper; Hospital discharge data; Prevalence; Substance abuse; Women

PMID:
25680703
PMCID:
PMC4802156
DOI:
10.1007/s10995-015-1730-1
[Indexed for MEDLINE]
Free PMC Article

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