Health, Retirement, and Long-Term Analysis Division, Congressional Budget Office, 441 D St SW, Washington, DC 20515, United States of America.
Department of Health Services Administration, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD 20742, United States of America.
J Subst Abuse Treat. 2019 Mar;98:53-58. doi: 10.1016/j.jsat.2018.12.009. Epub 2018 Dec 26.
Over 15 million Americans have alcohol use disorder (AUD). Detoxification often occurs before treatment and is, therefore, an important component of the alcohol treatment system. Detoxification in a residential setting is indicated for certain patient populations, who often have more severe cases. This analysis examines factors associated with completion of detoxification for patients with AUD in residential facilities.
We analyzed the 2006-2014 Treatment Episode Data Set - Discharges (TEDS-D) using logistic regression to estimate the association of a number of patient demographic, treatment, and disorder characteristics with completion of residential alcohol detoxification.
Social determinants of health were associated with detoxification completion. Patients who had a high school education or more and who were not homeless were more likely to complete detoxification. Referral from alcohol/drug care and other health care sources, school/work and community sources, and the criminal justice system had higher odds of completing detoxification. The odds of completing detoxification were lower for patients who began drinking at age 11 or younger, those with concurrent opioids, methamphetamine, or benzodiazepine abuse, and those with a co-occurring psychiatric condition.
The factors this study identified as being associated with lower odds of detoxification completion could be used to identify patients who would benefit from greater support during detoxification, treatment, and continuing care.
超过 1500 万美国人患有酒精使用障碍（AUD）。解毒通常发生在治疗之前，因此是酒精治疗系统的重要组成部分。在住院环境中进行解毒适用于某些特定的患者群体，这些患者的病情往往更为严重。本分析研究了与住院设施中 AUD 患者完成解毒相关的因素。
我们使用逻辑回归分析了 2006-2014 年治疗期数据集-出院（TEDS-D），以评估许多患者人口统计学、治疗和疾病特征与完成住院酒精解毒的关联。
健康的社会决定因素与解毒完成有关。具有高中或更高学历且无家可归的患者更有可能完成解毒。来自酒精/药物护理和其他医疗保健来源、学校/工作和社区来源以及刑事司法系统的转介有更高的完成解毒的几率。那些在 11 岁或更年轻时开始饮酒、同时滥用阿片类药物、甲基苯丙胺或苯二氮䓬类药物以及伴有共病精神疾病的患者，完成解毒的几率较低。
本研究确定的与解毒完成几率较低相关的因素可用于识别那些在解毒、治疗和持续护理期间需要更多支持的患者。
