OBJECTIVE: The study sought to determine whether inpatient readmission
rates differed for patients with substance use disorders who were treated
in either hospital-based or community-based transitional residential care.
Length of residential care and intensity of outpatient mental health
aftercare were examined as predictors of readmission. METHODS: Department
of Veterans Affairs nationwide databases were used to document readmissions
at one- and two-year intervals for male inpatients treated for substance
use disorders who were discharged either to hospital-based (N = 2,190) or
community-based (N = 4,490) residential care. Patients with and without
concomitant psychiatric diagnoses were identified. RESULTS: Patients
treated in community-based residential programs had lower one- and two-year
readmission rates than patients who received hospital-based residential
care. Longer episodes of residential care and more outpatient mental health
care were also associated with lower readmission rates. Among patients with
concomitant psychiatric disorders, those in hospital- based care benefited
more from longer episodes of residential care and more intensive outpatient
mental health aftercare. Residential care, longer episodes of care, and
more outpatient mental health care were independent predictors of lower
one- and two-year readmission rates after patient-based risk factors were
controlled. CONCLUSIONS: The findings highlight the value of providing
adequate amounts of residential and outpatient care for patients in
substance abuse treatment, especially patients with concomitant psychiatric
disorders.
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