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Rehospitalization and substance use disorder (SUD) treatment entry among patients seen by a hospital SUD consultation-liaison service.
Drug Alcohol Depend. 2018 05 01; 186:23-28.DA

Abstract

BACKGROUND

Substance use disorders (SUD) are associated with non-adherence to medical care and high utilization of hospital services. This study characterized patterns and correlates of rehospitalization among patients seen by a hospital-based SUD consultation-liaison (CL) team.

METHODS

This study was a retrospective medical record review of patients in a large urban academic hospital who received SUD consultation and were diagnosed with opioid, cocaine, and/or alcohol use disorder (N = 267). Data were collected on patient characteristics, substance-specific SUD diagnoses (opioids, cocaine, and alcohol), opioid agonist treatment (OAT) with methadone or buprenorphine (treatment status at admission; in-hospital initiation of OAT), and rehospitalization through 180 days post-discharge. Associations with rehospitalization were examined using bivariate tests of independence and multivariate logistic regression, with patient background and medical characteristics, substance-specific SUD diagnoses, and OAT status (at admission and in-hospital initiation) as predictors.

RESULTS

Rehospitalization rates were higher among patients with current opioid (38% vs. 24%; p < .05) and cocaine use disorders (39% vs. 26%; p < .05) compared to patients without these diagnoses. In multivariate logistic regression analysis, the number of medical comorbidities [Adjusted Odds Ratio (AOR) = 1.2; p < .01] and opioid use disorder (AOR = 2.4, p < .05) were independently associated with rehospitalization.

CONCLUSIONS

In this sample of hospital patients receiving SUD CL services, the risk of rehospitalization differed by type of SUD diagnosis. In-hospital initiation of OAT is promising for facilitating treatment linkage post-discharge, but this small study did not show differences in rehospitalization based on OAT initiation. These findings could inform services for hospital patients with comorbid SUDs.

Links

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Authors+Show Affiliations

Nordeck CD
Friends Research Institute, 1040 Park Avenue, Suite 103. Baltimore, MD 21201, USA.
Welsh C
Department of Psychiatry, Division of Alcohol and Drug Abuse, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA.
Schwartz RP
Friends Research Institute, 1040 Park Avenue, Suite 103. Baltimore, MD 21201, USA.
Mitchell SG
Friends Research Institute, 1040 Park Avenue, Suite 103. Baltimore, MD 21201, USA.
Cohen A
Department of Psychiatry, Division of Alcohol and Drug Abuse, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA.
O'Grady KE
Department of Psychology, University of Maryland, 4094 Campus Drive, College Park, MD 20742, USA.
Gryczynski J
Friends Research Institute, 1040 Park Avenue, Suite 103. Baltimore, MD 21201, USA. Electronic address: jgryczynski@friendsresearch.org.

MeSH

AdultFemaleHumansMaleMiddle AgedOpiate Substitution TreatmentPatient ReadmissionReferral and ConsultationRetrospective StudiesSubstance-Related Disorders

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29529456

Citation

Nordeck, Courtney D., et al. "Rehospitalization and Substance Use Disorder (SUD) Treatment Entry Among Patients Seen By a Hospital SUD Consultation-liaison Service." Drug and Alcohol Dependence, vol. 186, 2018, pp. 23-28.
Nordeck CD, Welsh C, Schwartz RP, et al. Rehospitalization and substance use disorder (SUD) treatment entry among patients seen by a hospital SUD consultation-liaison service. Drug Alcohol Depend. 2018;186:23-28.
Nordeck, C. D., Welsh, C., Schwartz, R. P., Mitchell, S. G., Cohen, A., O'Grady, K. E., & Gryczynski, J. (2018). Rehospitalization and substance use disorder (SUD) treatment entry among patients seen by a hospital SUD consultation-liaison service. Drug and Alcohol Dependence, 186, 23-28. https://doi.org/10.1016/j.drugalcdep.2017.12.043
Nordeck CD, et al. Rehospitalization and Substance Use Disorder (SUD) Treatment Entry Among Patients Seen By a Hospital SUD Consultation-liaison Service. Drug Alcohol Depend. 2018 05 1;186:23-28. PubMed PMID: 29529456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rehospitalization and substance use disorder (SUD) treatment entry among patients seen by a hospital SUD consultation-liaison service. AU - Nordeck,Courtney D, AU - Welsh,Christopher, AU - Schwartz,Robert P, AU - Mitchell,Shannon Gwin, AU - Cohen,Art, AU - O'Grady,Kevin E, AU - Gryczynski,Jan, Y1 - 2018/03/02/ PY - 2017/07/28/received PY - 2017/12/22/revised PY - 2017/12/23/accepted PY - 2018/3/13/pubmed PY - 2018/9/27/medline PY - 2018/3/13/entrez KW - Addiction KW - Consultation liaison KW - Hospital KW - Opioid use disorder KW - Readmission KW - Treatment linkage SP - 23 EP - 28 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 186 N2 - BACKGROUND: Substance use disorders (SUD) are associated with non-adherence to medical care and high utilization of hospital services. This study characterized patterns and correlates of rehospitalization among patients seen by a hospital-based SUD consultation-liaison (CL) team. METHODS: This study was a retrospective medical record review of patients in a large urban academic hospital who received SUD consultation and were diagnosed with opioid, cocaine, and/or alcohol use disorder (N = 267). Data were collected on patient characteristics, substance-specific SUD diagnoses (opioids, cocaine, and alcohol), opioid agonist treatment (OAT) with methadone or buprenorphine (treatment status at admission; in-hospital initiation of OAT), and rehospitalization through 180 days post-discharge. Associations with rehospitalization were examined using bivariate tests of independence and multivariate logistic regression, with patient background and medical characteristics, substance-specific SUD diagnoses, and OAT status (at admission and in-hospital initiation) as predictors. RESULTS: Rehospitalization rates were higher among patients with current opioid (38% vs. 24%; p < .05) and cocaine use disorders (39% vs. 26%; p < .05) compared to patients without these diagnoses. In multivariate logistic regression analysis, the number of medical comorbidities [Adjusted Odds Ratio (AOR) = 1.2; p < .01] and opioid use disorder (AOR = 2.4, p < .05) were independently associated with rehospitalization. CONCLUSIONS: In this sample of hospital patients receiving SUD CL services, the risk of rehospitalization differed by type of SUD diagnosis. In-hospital initiation of OAT is promising for facilitating treatment linkage post-discharge, but this small study did not show differences in rehospitalization based on OAT initiation. These findings could inform services for hospital patients with comorbid SUDs. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/29529456/Rehospitalization_and_substance_use_disorder__SUD__treatment_entry_among_patients_seen_by_a_hospital_SUD_consultation_liaison_service_ DB - PRIME DP - Unbound Medicine ER -