Diagnostic inconsistency: a marker of service utilization in bipolar disorder.

Community outcomes for the treatment of bipolar disorder remain poor, including frequent hospitalization. Recent small-scale studies suggest that hospitalization may be tied to poor recognition and medication management. This paper examines the health care charges associated with poor recognition of mania. Service utilization was analyzed for 3,856 individuals with bipolar disorder in a managed care plan. Only 8.2% of patients were diagnosed with bipolar disorder, however they accounted for 45% of inpatient charges. Among patients with bipolar disorder, cases where diagnoses were changed to unipolar depression were hospitalized more quickly. Interventions are suggested to increase consistent recognition of manic history.