Health Services Research and Development, VA Puget Sound Health Care System, Seattle, WA, USA.
J Subst Abuse Treat. 2012 Sep;43(2):221-30. doi: 10.1016/j.jsat.2011.11.002. Epub 2011 Dec 23.
Although substance use disorders (SUDs) are chronic conditions for many patients, the prevalence, predictors, and health care utilization patterns of those who reenter SUD specialty care are understudied. We identified 1,640 patients who initiated SUD specialty care at 1 Veterans Affairs (VA) medical center and categorized them, using their subsequent 24 and prior 60 months receipt of VA SUD care, as index episode only (35.7%, 33.5-38.1), index and prior episode(s) (24.6%, 22.5-22.7), and index and postindex episodes (39.6%, 37.3-42.0). Compared with the index episode-only group, the postindex episode(s) group had modestly higher percentages of men, divorced/separated, and alcohol use, cocaine use, bipolar disorder, and psychotic disorders. Patients with postindex episodes averaged 2 times more postindex emergency visits and mental health hospitalizations than patients with an index only episode. Results document the prevalence, overall health care utilization, and limited predictability of SUD treatment reentry and support development of new models of care for these complex patients.
虽然物质使用障碍（SUD）对许多患者来说是慢性疾病，但重新进入 SUD 专科治疗的患者的流行率、预测因素和医疗保健利用模式仍研究不足。我们在 1 家退伍军人事务部（VA）医疗中心确定了 1640 名开始 SUD 专科治疗的患者，并根据他们随后的 24 个月和之前的 60 个月接受 VA SUD 治疗的情况，将他们分为仅索引发作组（35.7%，33.5-38.1%）、索引和先前发作组（24.6%，22.5-22.7%）和索引和后索引发作组（39.6%，37.3-42.0%）。与仅索引发作组相比，后索引发作组的男性、离婚/分居、酒精使用、可卡因使用、双相情感障碍和精神病障碍的比例略高。后索引发作的患者平均比仅有索引发作的患者在后索引发作期间有更多的急诊就诊和心理健康住院治疗。研究结果记录了 SUD 治疗重新进入的流行率、总体医疗保健利用情况和有限的可预测性，并支持为这些复杂患者开发新的护理模式。
