The 130th Annual Meeting of APHA

3289.0: Monday, November 11, 2002 - 4:30 PM

Abstract #39010

Trends in inpatient detoxification services and linkages to treatment

Tami L. Mark, PhD1, Joan D Dilonardo, PhD2, Mady Chalk, PhD2, and Rosanna M. Coffey, PhD1. (1) Outcomes Research and Econometrics, The Medstat Group, 4301 Connecticut Avenue, NW, Washington, DC 20008, (2) Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockwall II Building, Suite 740, 5515 Security Lane, Rockville, MD 20852

Objective: The paper examines trends in the use of inpatient substance abuse detoxification provided at general hospitals. Methods. Used data from the 1992 and 1997 Healthcare Utilization and Cost Project National Inpatient Survey (HCUP-NIS). Patients receiving detoxification while inpatients were identified through ICD-9-CM procedure codes. The subset of the study population who had treatment during a hospital stay for substance abuse or dependence was identified also using procedure codes. Results: Most persons who received inpatient detoxification did not also receive treatment while an inpatient. The percentage receiving treatment declined between 1992 and 1997 from 38.9% to 21.1%. The decrease in the probability of receiving treatment occurred across gender, age, region, insurance status, income levels, diagnoses, admission source, and discharge destination. Two other notable trends are that average length of stay for detoxification dropped by one-third over the six-year period, from 7.7 days to 5.2 days and the percentage of admissions through the emergency room increased from 35.6 percent to 40.1 percent. Conclusions. Patients who receive detoxification alone, in comparison to persons who receive detoxification and substance abuse treatment, are much less likely to be have a good outcome in terms of abstinence at a later point in time. Detoxification offers an opportunity to link patients with treatment. This analysis indicates that those opportunities may be missed. Efforts to increase linkages might include performance monitoring and improved discharge planning, however, more research is needed on the most effective methods for improving linkages between detoxification and treatment.

Learning Objectives:

Keywords: Substance Abuse Treatment, Quality of Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Continuity of Care

The 130th Annual Meeting of APHA