Blanchard Janice, Weiss Audrey J, Barrett Marguerite L, Stocks Carol, Owens Pamela L, Coffey Rosanna, Heslin Kevin C
a RAND Corporation , Arlington , Virginia , USA.
b George Washington University , Washington , DC , USA.
Subst Use Misuse. 2019;54(3):473-481. doi: 10.1080/10826084.2018.1517174. Epub 2019 Jan 8.
Previous research suggests that relatively few hospitalized patients with opioid-related conditions receive substance use treatment during their inpatient stay. Without treatment, these individuals may be more likely to have subsequent hospitalizations for continued opioid use disorder.
To evaluate the relationship between receipt of inpatient drug detoxification and/or rehabilitation services and subsequent opioid-related readmission.
This study used combined hospital inpatient discharge and emergency department visit data from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project. Our sample consisted of 329,037 patients from seven states with an opioid-related index hospitalization occurring between March 2010 and September 2013. Multivariate analysis was conducted to examine the relationship between opioid-related readmission and the receipt of inpatient drug detoxification and/or rehabilitation during the index visit.
A relatively small percentage (19.4%) of patients with identified opioid-related conditions received treatment for drug use during their hospital inpatient stay. Patients who received drug rehabilitation, but not drug detoxification, during an opioid-related index hospitalization had lower odds of an opioid-related readmission within 90 days of discharge (odds ratio = 0.60, 95% confidence interval = 0.54-0.67) compared with patients with no inpatient drug detoxification or rehabilitation. Conclusions/Importance: A low percentage of patients receive inpatient services for drug use during an index stay involving an opioid-related diagnosis. Our findings indicate that receipt of drug rehabilitation services in acute care hospitals is associated with a lower 90-day readmission rate. Further research is needed to understand factors associated with the receipt of inpatient services and readmissions.
先前的研究表明，相对较少的患有阿片类药物相关疾病的住院患者在住院期间接受物质使用治疗。如果不接受治疗，这些人可能更有可能因持续的阿片类药物使用障碍而再次住院。
评估住院药物戒毒和/或康复服务的接受情况与随后的阿片类药物相关再入院之间的关系。
本研究使用了来自医疗保健研究与质量局的医疗保健成本与利用项目的综合医院住院出院和急诊科就诊数据。我们的样本包括来自七个州的329,037名患者，他们在2010年3月至2013年9月期间因阿片类药物相关的首次住院治疗。进行多变量分析以检查阿片类药物相关再入院与首次就诊期间住院药物戒毒和/或康复服务接受情况之间的关系。
在确定患有阿片类药物相关疾病的患者中，相对较小比例（19.4%）的患者在住院期间接受了药物使用治疗。与未接受住院药物戒毒或康复的患者相比，在阿片类药物相关的首次住院期间接受药物康复但未接受药物戒毒的患者在出院后90天内阿片类药物相关再入院的几率较低（比值比=0.60，95%置信区间=0.54-0.67）。结论/重要性：在涉及阿片类药物相关诊断的首次住院期间，接受住院药物使用服务的患者比例较低。我们的研究结果表明，在急性护理医院接受药物康复服务与较低的90天再入院率相关。需要进一步研究以了解与接受住院服务和再入院相关的因素。
