A national study for regional variation of inpatient ECT utilization from 4,411 hospitals across the United States

background: We conducted a study to examine regional variation in the utilization of inpatient electroconvulsive therapy (ECT) across the United States, and its impact on length of hospital stay and cost. methods: Analysis of the Nationwide Inpatient Sample databases to com-pare patient and hospital characteristics, and regional variation of ECT administration across different regions of the United States. RESULTS: The study included 41,055 inpatients who had ECT from 4,411 hos-pitals. Electroconvulsive therapy use is significantly higher in the Midwest. A higher proportion of females (65.2%) than males received ECT across the United States. Medicaid beneficiaries were less likely to undergo ECT compared with patients with Medicare (52.2%) or private insurance (32%). Electroconvulsive therapy was used mainly for mood disorders (84.3%). There were marked reductions of inpatient costs ($25,298 to $38,244) and average hospital stay (16 days) when ECT was initiated within the first 5 days of admission compared with later during the hospitalization. conclusions: There is a wide variability of utilization of ECT, depending on the region, type of hospital, and type of insurance carrier. The utiliza-tion of ECT services is reduced across the United States. Appropriate uti-lization of this effective treatment can greatly help patients who are not responding to standard therapeutics, reduce overall health care cost and length of stay, and, most importantly, alleviate suffering.