Longer episodes of community residential care reduce substance abuse patients' readmission rates.
OBJECTIVE
The study focuses on whether substance abuse patients who enter a community residential facility (CRF) after discharge from inpatient care obtain more outpatient mental health care and have lower readmission rates than comparable patients discharged directly to the community.


METHODS
A national sample of substance abuse patients (N = 5,176; 99% men) referred to CRFs after inpatient substance abuse care is compared to a matched sample of patients (N = 5,176; 99% men) discharged to the community.


RESULTS
Compared with controls, CRF patients were more likely to obtain outpatient mental health aftercare and obtained more intensive care. Patients with longer episodes of CRF care had lower 6-month and 1-year readmission rates than patients who dropped out of CRFs and than matched controls. These findings held for patients who had only alcohol diagnoses, patients who had drug diagnoses and patients who had psychiatric diagnoses in addition to their substance abuse disorders. Longer length of CRF care and more outpatient mental health care were significant predictors of lower readmission rates after other risk factors for readmission were controlled.


CONCLUSIONS
Longer episodes of community residential care can contribute to better outcomes for substance abuse patients, in part by maintaining patients' involvement in outpatient mental health care. CRFs may play an important role in the continuum of substance abuse patients' care.
Moos
R H
RH
Program Evaluation and Resource Center, Department of Veterans Affairs Medical Center, Palo Alto, California 94304, USA.
Pettit
B
B
Gruber
V
V
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D003155:Community Mental Health Centers / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006208:Halfway Houses / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012008:Recurrence; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*