title: Post-Discharge Treatment Engagement Among Patients with an Opioid-Use Disorder.
abstract: Opioid misuse is a growing public health problem, and estimates show a 150% increase in opioid-related hospital stays over the last two decades. This study examined factors associated with substance use treatment engagement following a hospitalization for opioid use disorder or overdose.
  
  
  
  This study analyzed the Truven Health Analytics MarketScan® Commercial Claims and Encounters (CCAE) database for 2010 through 2014 to study post-hospitalization substance use disorder (SUD) treatment of individuals aged 18-64 who had an inpatient admission for an opioid-use disorder or opioid overdose. Engagement in post-discharge SUD treatment was defined as having at least two unique outpatient visits within 30 days of a hospitalization. Generalized estimating equations (GEEs) with a binomial link were used to determine the factors associated with SUD treatment engagement.
  
  
  
  Only 17% of patients engaged in SUD treatment within 30 days of hospital discharge. A behavioral health outpatient visit prior to the SUD admission increased the odds of engaging in SUD treatment by 1.34 (CI: 1.25-1.45), an antidepressant prescription drug fill prior to the SUD admission increased the odds by 1.14 (CI: 1.07-1.21), a benzodiazepine fill prior to the SUD admission increased the odds by 1.14 (CI: 1.07-1.21), a principal diagnosis for an SUD at index admission increased the odds by 2.13 (CI: 1.97-2.30), an alcohol-related disorder diagnosis at index admission increased the odds by 3.13 (CI: 2.87-3.42), and an additional SUD diagnosis at the index admission increased the odds by 2.72 (CI: 2.48-2.98).
  
  
  
  We found low rates of SUD treatment engagement following hospitalizations for opioid use disorders and overdoses. Patients with prior engagements with behavioral health providers were more likely to engage in follow-up care; therefore, providers may need to focus additional efforts on patients admitted to the hospital with opioid-use disorders who do not have an existing provider relationship.
authors: Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857. Electronic address: Sarah.Naeger@samhsa.hhs.gov.
authors: Sarah
authors: S
authors: Naeger
authors: Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857. Electronic address: Ryan.mutter@samhsa.hhs.gov.
authors: Ryan
authors: R
authors: Mutter
authors: Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857. Electronic address: Mir.ali@samhsa.hhs.gov.
authors: Mir M
authors: MM
authors: Ali
authors: Truven Health Analytics, 7700 Old Georgetown Road, Bethesda, MD 20814. Electronic address: Tami.mark@truvenhealth.com.
authors: Tami
authors: T
authors: Mark
authors: Truven Health Analytics, 7700 Old Georgetown Road, Bethesda, MD 20814. Electronic address: lauren.hughey@truvenhealth.com.
authors: Lauren
authors: L
authors: Hughey
mesh_terms: D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D016208:Databases, Factual; D062787:Drug Overdose / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010351:Patient Discharge; D063487:Prescription Drug Misuse; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Opioid related hospitalization; Opioid-use disorder; Patient; Post-discharge treatment