Inpatient addiction consultation and post-discharge 30-day acute care utilization

Weinstein, Zoe; Cheng, Debbie M.; D'Amico, Maria J; Forman, Leah S; Regan, Danny; Yurkovic, Alexandra; Samet, Jeffrey H.; Walley, Alexander Y.

doi:10.1016/j.drugalcdep.2020.108081

Cited by 21 publications

(53 citation statements)

References 47 publications

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“…Hospital-based SUD treatment can reduce post-hospital substance use [36], increase engagement in post-hospital SUD treatment [13], and improve care quality [37,38]. Evidence is mixed as to effects of hospital-based addictions care on readmissions for SBI [13,34,[39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Population-based trends in hospitalizations due to injection drug use-related serious bacterial infections, Oregon, 2008 to 2018

Capizzi

Leahy

Wheelock³

et al. 2020

PLoS ONE

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Background Injection drug use has far-reaching social, economic, and health consequences. Serious bacterial infections, including skin/soft tissue infections, osteomyelitis, bacteremia, and endocarditis, are particularly morbid and mortal consequences of injection drug use. Methods We conducted a population-based retrospective cohort analysis of hospitalizations among patients with a diagnosis code for substance use and a serious bacterial infection during the same hospital admission using Oregon Hospital Discharge Data. We examined trends in hospitalizations and costs of hospitalizations attributable to injection drug use-related serious bacterial infections from January 1, 2008 through December 31, 2018. Results From 2008 to 2018, Oregon hospital discharge data included 4,084,743 hospitalizations among 2,090,359 patients. During the study period, hospitalizations for injection drug use-related serious bacterial infection increased from 980 to 6,265 per year, or from 0.26% to 1.68% of all hospitalizations (P<0.001). The number of unique patients with an injection drug use-related serious bacterial infection increased from 839 to 5,055, or from 2.52% to 8.46% of all patients (P<0.001). While hospitalizations for all injection drug use-related serious bacterial infections increased over the study period, bacteremia/sepsis hospitalizations rose most rapidly with an 18-fold increase. Opioid use diagnoses accounted for the largest percentage of hospitalizations for injection drug use-related serious bacterial infections, but hospitalizations for amphetamine-type stimulant-related serious bacterial infections rose most rapidly with a 15-fold increase. People living with HIV and HCV experienced increases in hospitalizations for injection drug use-related serious bacterial infection during the study period. Overall, the total cost of hospitalizations for injection drug use-related serious bacterial infections increased from $16,305,129 in 2008 to $150,879,237 in 2018 (P<0.001). Conclusions In Oregon, hospitalizations for injection drug use-related serious bacterial infections increased dramatically and exacted a substantial cost on the health care system from 2008 to 2018. This increase in hospitalizations represents an opportunity to initiate substance use disorder treatment and harm reduction services to improve outcomes for people who inject drugs.

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Section: Discussionmentioning

confidence: 99%

Population-based trends in hospitalizations due to injection drug use-related serious bacterial infections, Oregon, 2008 to 2018

Capizzi

Leahy

Wheelock³

et al. 2020

PLoS ONE

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“…The examined variables ranged from 5 (Ortiz 2019) to 56 (Weinstein et al . 2020). The statistically significant risk factors were then grouped under three subheadings: Pre‐index admission, index admission and post‐index admission.…”

Section: Resultsmentioning

confidence: 99%

“…On the contrary, when the reference group was >85 years, patients aged 18–64 years had a 10–28% more chance of being readmitted (Weinstein et al . 2020).…”

Section: Resultsmentioning

confidence: 99%

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Risk factors associated with 30‐day unplanned hospital readmission for patients with mental illness

Zhou

Ngune

Albrecht

et al. 2022

Int J Mental Health Nurs

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Unplanned hospital readmission rate is up to 43% in mental health settings, which is higher than in general health settings. Unplanned readmissions delay the recovery of patients with mental illness and add financial burden on families and healthcare services. There have been efforts to reduce readmissions with a particular interest in identifying patients at higher readmission risk after index admission; however, the results have been inconsistent. This systematic review synthesized risk factors associated with 30-day unplanned hospital readmissions for patients with mental illness. Eleven electronic databases were searched from 2010 to 30 September 2021 using key terms of 'mental illness', 'readmission' and 'risk factors'. Sixteen studies met the selection criteria for this review. Data were synthesized using content analysis and presented in narrative and tabular form because the extracted risk factors could not be pooled statistically due to methodological heterogeneity of the included studies. Consistently cited readmission predictors were patients with lower educational background, unemployment, previous mental illness hospital admission and more than 7 days of the index hospitalization. Results revealed the complexity of identifying unplanned hospital readmission predictors for people with mental illness. Policymakers need to specify the expected standards that written discharge summary must reach general practitioners concurrently at discharge. Hospital clinicians should ensure that discharge summary summaries are distributed to general practitioners for effective ongoing patient care and management. Having an advanced mental health nurse for patients during their transition period needs to be explored to understand how this role could ensure referrals to the general practitioner are eventuated.

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“…One potential strategy is wider access to inpatient multidisciplinary addiction medicine consult teams (AMCT) that offer wraparound supports. Recent studies show that AMCTs can help connect PWUD to primary care, housing supports, ID registries, income assistance, and substance use treatment [38,39]. However, it is important to note that the effectiveness of AMCTs depends on strong primary care and community service supports.…”

Section: Discussionmentioning

confidence: 99%

Perceived unmet substance use and mental health care needs of acute care patients who use drugs: A cross‐sectional analysis using the Behavioral Model for Vulnerable Populations

Kosteniuk

Salvalaggio

Wild

et al. 2021

Drug and Alcohol Review

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Introduction. The perceived unmet service needs of acute care-seeking people who use illegal drugs (PWUD) have been poorly documented, despite evidence of frequent hospital utilisation. This study applies the Behavioral Model for Vulnerable Populations to investigate correlates of unmet service needs in this subpopulation. Methods. Survey data from 285 PWUD at three urban Canadian acute care centres were examined. The survey included the Perceived Need for Care Questionnaire, which measured service seeking and care satisfaction for mental health and substance use concerns across seven types of services, as well as barriers to having care needs met. The Behavioral Model for Vulnerable Populations was applied in hierarchical setwise logistic regression to examine associations between high unmet service need and socio-structural predictors (i.e. predisposing, enabling and need factors). Results. Almost half (46%) of participants reported a high level of unmet service need, despite seeking services during the past year. Participants reporting recent criminal activity, adverse childhood experiences, transitory sleeping, having no community support worker, and meeting screening criteria for depression were more likely to report a high level of unmet service needs. Structural barriers to care (57%) were more commonly reported than motivational barriers (43%). Discussion and Conclusions. Acute care-seeking PWUD experience high rates of unmet service needs for their mental health and substance use problems. Strategies that can help overcome structural barriers to care are necessary to help address the service needs of this population. [Kosteniuk B, Salvalaggio G, Wild TC, Gelberg L, Hyshka E. Perceived unmet substance use and mental health care needs of acute care patients who use drugs: A cross-sectional analysis using the Behavioral Model for Vulnerable Populations.

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Inpatient addiction consultation and post-discharge 30-day acute care utilization

Cited by 21 publications

References 47 publications

Population-based trends in hospitalizations due to injection drug use-related serious bacterial infections, Oregon, 2008 to 2018

Population-based trends in hospitalizations due to injection drug use-related serious bacterial infections, Oregon, 2008 to 2018

Risk factors associated with 30‐day unplanned hospital readmission for patients with mental illness

Perceived unmet substance use and mental health care needs of acute care patients who use drugs: A cross‐sectional analysis using the Behavioral Model for Vulnerable Populations

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