Readmission among chemical dependency patients in private, outpatient treatment: patterns, correlates and role in long-term outcome.

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.
METHOD: 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.