title: Readmission among chemical dependency patients in private, outpatient treatment: patterns, correlates and role in long-term outcome.
abstract: OBJECTIVE
  Similar to other chronic conditions, chemical dependency is a chronic, relapsing condition. Yet predominant treatment models do not provide ongoing, long-term treatment services; readmission is the available long-term care for alcohol and drug patients. We examine readmission patterns and the role of readmission in 5-year outcome in chemical dependency patients in a private, integrated health plan.
  
  
  METHODS
  We used health plan utilization databases and self-report at 5-year follow-up to measure readmission and routine primary care services in 647 chemical dependency outpatients from a private health plan. Logistic regression was used to examine whether readmission and primary medical care predicted abstinence at 5 years.
  
  
  RESULTS
  Controlling for demographic characteristics and dependence type, higher odds for past-year alcohol and drug abstinence at 5 years following treatment was predicted by having been readmitted in the first 4 years after index episode (odds ratio =1.59, p = .006). Receiving routine medical care predicted past 30-day (but not past-year) abstinence at 5-year follow-up.
  
  
  CONCLUSIONS
  The relationship of readmissions to better outcome at 5 years suggests that long-term continuing care may benefit patients' long-term outcomes. More research is needed on the relationship of primary medical care to long-term outcome in chemical dependency patients.
authors.affiliation: Division of Research, Kaiser Permanente Northern California, 2000 Broadway, 3rd floor, Oakland, California 94612-2304, USA. Jennifer.Mertens@kp.org
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Mertens
authors.forename: Constance M
authors.initials: CM
authors.lastname: Weisner
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Ray
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000379:methods* / Q000706:statistics & numerical data*; D002908:Chronic Disease; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D017149:Private Sector; D012008:Recurrence; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D013995:Time; D016896:Treatment Outcome