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Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service.
PLoS One. 2020; 15(10):e0239761.Plos

Abstract

BACKGROUND

Addiction medicine consultation services (ACS) may improve outcomes of hospitalized patients with substance use disorders (SUD). Our aim was to examine the difference in length of stay and the hazard ratio for a routine hospital discharge between SUD patients receiving and not receiving ACS.

METHODS

Structured EHR data from 2018 of 1,900 adult patients with a SUD-related diagnostic code at an urban academic health center were examined among 35,541 total encounters. Cox proportional hazards regression models were fit using a cause-specific approach to examine differences in hospital outcome (i.e., routine discharge, leaving against medical advice, in-hospital death, or transfer to another level of care). Models were adjusted for age, sex, race, ethnicity, insurance status, and comorbidities.

RESULTS

Length of stay was shorter among encounters with a SUD that received a SUIT consultation versus those admissions that did not receive one (5.77 v. 6.54 days, p<0.01). In adjusted analyses, admissions that received a SUIT consultation had a higher hazard of a routine discharge [hazard ratio (95% confidence interval): 1.16 (1.03-1.30)] compared to those not receiving a SUIT consultation.

CONCLUSIONS

The SUIT consultation service was associated with a reduced length of stay and an increased hazard of a routine discharge. The SUIT model may serve as a benchmark and inform other health systems attempting to improve outcomes in SUD patient cohorts.

Links

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Authors+Show Affiliations

Thompson HM
Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America.
Faig W
Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America.
VanKim NA
Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America.
Sharma B
Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America.
Afshar M
Division of Pulmonary and Critical Care, Department of Public Health Sciences, Center for Health Outcomes & Informatics Research, Loyola University, Maywood, IL, United States of America.
Karnik NS
Department of Psychiatry & Behavioral Sciences, Section of Community Behavioral Health, Rush University Medical Center, Chicago, IL, United States of America.

MeSH

Behavior, AddictiveComorbidityFemaleHospitalizationHumansLength of StayMaleMiddle AgedPatient DischargePatient ReadmissionProportional Hazards ModelsReferral and ConsultationSubstance-Related Disorders

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

33035229

Citation

Thompson, Hale M., et al. "Differences in Length of Stay and Discharge Destination Among Patients With Substance Use Disorders: the Effect of Substance Use Intervention Team (SUIT) Consultation Service." PloS One, vol. 15, no. 10, 2020, pp. e0239761.
Thompson HM, Faig W, VanKim NA, et al. Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service. PLoS One. 2020;15(10):e0239761.
Thompson, H. M., Faig, W., VanKim, N. A., Sharma, B., Afshar, M., & Karnik, N. S. (2020). Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service. PloS One, 15(10), e0239761. https://doi.org/10.1371/journal.pone.0239761
Thompson HM, et al. Differences in Length of Stay and Discharge Destination Among Patients With Substance Use Disorders: the Effect of Substance Use Intervention Team (SUIT) Consultation Service. PLoS One. 2020;15(10):e0239761. PubMed PMID: 33035229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differences in length of stay and discharge destination among patients with substance use disorders: The effect of Substance Use Intervention Team (SUIT) consultation service. AU - Thompson,Hale M, AU - Faig,Walter, AU - VanKim,Nicole A, AU - Sharma,Brihat, AU - Afshar,Majid, AU - Karnik,Niranjan S, Y1 - 2020/10/09/ PY - 2020/02/24/received PY - 2020/09/13/accepted PY - 2020/10/9/entrez PY - 2020/10/10/pubmed PY - 2020/11/21/medline SP - e0239761 EP - e0239761 JF - PloS one JO - PLoS One VL - 15 IS - 10 N2 - BACKGROUND: Addiction medicine consultation services (ACS) may improve outcomes of hospitalized patients with substance use disorders (SUD). Our aim was to examine the difference in length of stay and the hazard ratio for a routine hospital discharge between SUD patients receiving and not receiving ACS. METHODS: Structured EHR data from 2018 of 1,900 adult patients with a SUD-related diagnostic code at an urban academic health center were examined among 35,541 total encounters. Cox proportional hazards regression models were fit using a cause-specific approach to examine differences in hospital outcome (i.e., routine discharge, leaving against medical advice, in-hospital death, or transfer to another level of care). Models were adjusted for age, sex, race, ethnicity, insurance status, and comorbidities. RESULTS: Length of stay was shorter among encounters with a SUD that received a SUIT consultation versus those admissions that did not receive one (5.77 v. 6.54 days, p<0.01). In adjusted analyses, admissions that received a SUIT consultation had a higher hazard of a routine discharge [hazard ratio (95% confidence interval): 1.16 (1.03-1.30)] compared to those not receiving a SUIT consultation. CONCLUSIONS: The SUIT consultation service was associated with a reduced length of stay and an increased hazard of a routine discharge. The SUIT model may serve as a benchmark and inform other health systems attempting to improve outcomes in SUD patient cohorts. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/33035229/Differences_in_length_of_stay_and_discharge_destination_among_patients_with_substance_use_disorders:_The_effect_of_Substance_Use_Intervention_Team__SUIT__consultation_service_ DB - PRIME DP - Unbound Medicine ER -