From the Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, New York, NY (NK, BDR); Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY (JEC, ZL); and Ohio University Heritage College of Osteopathic Medicine, Appalachian Institute to Advance Health Equity Science (ADVANCE), Athens, OH (BF).
J Addict Med. 2024;18(2):115-121. doi: 10.1097/ADM.0000000000001250. Epub 2023 Nov 24.
Hospitals are a key touchpoint to reach patients with substance use disorders (SUDs) and link them with ongoing community-based services. Although there are many acute care interventions to initiate SUD treatment in hospital settings, less is known about what services are offered to transition patients to ongoing care after discharge. In this study, we explore what SUD care transition strategies are offered across nonprofit US hospitals.
We analyzed administrative documents from a national sample of US hospitals that indicated SUD as a top 5 significant community need in their Community Health Needs Assessment reports (2019-2021). Data were coded and categorized based on the nature of described services. We used data on hospitals and characteristics of surrounding counties to identify factors associated with hospitals' endorsement of transition interventions for SUD.
Of 613 included hospitals, 313 prioritized SUD as a significant community need. Fifty-three of these hospitals (17%) offered acute care interventions to support patients' transition to community-based SUD services. Most (68%) of the 53 hospitals described transition strategies without further detail, 23% described scheduling appointments before discharge, and 11% described discussing treatment options before discharge. No hospital characteristics were associated with offering transition interventions, but such hospitals were more likely to be in the Northeast, in counties with higher median income, and states that expanded Medicaid.
Despite high need, most US hospitals are not offering interventions to link patients with SUD from acute to community care. Efforts to increase acute care interventions for SUD should identify and implement best practices to support care continuity.
医院是接触患有物质使用障碍（SUD）的患者并将其与持续的社区为基础的服务联系起来的关键接触点。尽管有许多急性护理干预措施可以在医院环境中启动 SUD 治疗，但对于提供哪些服务来帮助患者在出院后过渡到持续治疗，了解较少。在这项研究中，我们探讨了非营利性美国医院提供了哪些 SUD 护理过渡策略。
我们分析了来自美国全国样本医院的行政文件，这些医院在其社区健康需求评估报告（2019-2021 年）中表明 SUD 是其前 5 大社区需求之一。数据根据描述服务的性质进行编码和分类。我们使用有关医院和周边县特征的数据，确定与医院支持 SUD 过渡干预措施的因素相关的因素。
在 613 家纳入的医院中，有 313 家将 SUD 作为重要的社区需求。在这 313 家医院中，有 53 家（17%）提供急性护理干预措施，以支持患者向社区 SUD 服务过渡。这 53 家医院中的大多数（68%）都描述了过渡策略，但没有进一步详细说明，23%的医院在出院前安排预约，11%的医院在出院前讨论治疗方案。没有医院特征与提供过渡干预措施相关，但这些医院更有可能位于东北部，所在县的中位收入更高，所在州扩大了医疗补助。
尽管需求很高，但大多数美国医院并未提供将 SUD 患者从急性护理过渡到社区护理的干预措施。增加 SUD 急性护理干预的努力应确定并实施最佳实践，以支持护理连续性。
