Substance use treatment barriers for patients with frequent hospital admissions.
Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identified by a validated statistical algorithm as being at high-risk for frequent hospitalizations were interviewed at an urban public hospital. Patient drug/alcohol history, experiences with medical, psychiatric and addiction treatment, and social factors contributing to readmission were evaluated. Three themes related to SU and frequent hospitalizations emerged: (a) barriers during hospitalization to planning long-term treatment and follow-up, (b) use of the hospital as a temporary solution to housing/family problems, and (c) unsuccessful SU aftercare following discharge. These data indicate that homelessness, brief lengths of stay complicating discharge planning, patient ambivalence regarding long-term treatment, and inadequate detox-to-rehab transfer resources compromise substance-using patients' likelihood of avoiding repeat hospitalization. Intervention targets included supportive housing, detox-to-rehab transportation, and postdischarge patient support.
Raven
Maria C
MC
Department of Emergency Medicine, Division of General Internal Medicine, NYU School of Medicine/Bellevue Hospital Center, New York, NY 10016, USA. maria.raven@med.nyu.edu
Carrier
Emily R
ER
Lee
Joshua
J
Billings
John C
JC
Marr
Mollie
M
Gourevitch
Marc N
MN
D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care; D005260:Female; D006300:Health Services Misuse / Q000639:trends*; D006703:Ill-Housed Persons; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D019966:Substance-Related Disorders / Q000628:therapy*; D014481:United States