Risk factors associated with dropout and readmission among First Nations individuals admitted to an inpatient alcohol and drug detoxification program.
BACKGROUND
There is a need for clinically relevant research into treatment for substance abuse among Aboriginal people. In this study, I aimed to provide a predictive model of dropout from and readmission to an inpatient detoxification program in a large treatment sample of Aboriginal patients.


METHODS
I reviewed the medical charts of all self-reported First Nations people (n = 877) admitted to an inpatient detoxification centre in British Columbia, between Jan. 4, 1999, and Jan. 30, 2002, and used binary logistic regression models to identify predictors of dropout from and readmission to the program. Each of these models was validated using an independent subset of the treatment sample.


RESULTS
Overall, 254 (29.0%) people dropped out of the program, and 219 were readmitted. Statistically significant predictors of treatment dropout were a preferred drug other than alcohol (odds ratio [OR] 1.67, 95% confidence interval [CI] 1.12-2.50) and self-referral (OR 1.89, 95% CI 1.28-2.80). Statistically significant predictors of readmission to inpatient detoxification within a 1-year period were a previous history of detoxification treatment (OR 3.52, 95% CI 2.16-5.75) and residential instability (OR 1.82, 95% CI 1.11-2.99).


CONCLUSIONS
Although factors were identified that are associated with each of treatment dropout or readmission for detoxification, only the latter can be reliably predicted by them.
Callaghan
Russell C
RC
Department of Psychology, University of Toronto, Toronto, Ont. Russell_Callaghan@camh.net
D000328:Adult; D001955:British Columbia; D005260:Female; D006302:Health Services Research; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012008:Recurrence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000208:ethnology* / Q000534:rehabilitation; D016896:Treatment Outcome; D014478:Unemployment / Q000523:psychology / Q000706:statistics & numerical data