Bradley D Stein1, Jane N Kogan, Mark Sorbero. 1. Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 Ohara St., Pittsburgh, PA 15213, USA. steinbd@upmc.edu
Abstract
BACKGROUND: Substance use disorders are chronic disorders with substantial public health significance, yet the treatment provided is often episodic despite ongoing need. Among the more severely ill individuals requiring detoxification or residential treatment, little empirical information is available about rates and predictors of subsequent engagement in necessary subsequent treatment. METHODS: Using administrative data from the largest Medicaid managed behavioral health organization in a large mid-Atlantic state, we used multivariate regression to examine rates and predictors of subsequent treatment engagement and retention following new episodes of detoxification or residential substance abuse treatment among 5670 Medicaid-enrolled adults during 2004-2006. RESULTS: Slightly less than half (49%) of the sample received follow-up care within 30 days of discharge. Rates of follow-up were significantly higher in individuals with a serious mental illness, and significantly lower in African-American individuals, males, individuals with disabilities, and those who received detoxification without residential treatment. The mean duration of follow-up treatment was 84 days, and was longer among individuals with a serious mental illness and Caucasians. Even after controlling for individuals' sociodemographic and clinical characteristics, there was substantial variation in follow-up rates among discharging providers. CONCLUSION: The relatively low rates of follow-up care and relatively brief duration of treatment for many of those who received such follow-up care are concerning in a population receiving substance abuse detoxification or residential treatment. The markedly lower rates among those receiving detoxification alone without subsequent residential treatment and among those without a comorbid serious mental illness suggest that efforts specifically targeting those individuals may be of particular benefit.
BACKGROUND: Substance use disorders are chronic disorders with substantial public health significance, yet the treatment provided is often episodic despite ongoing need. Among the more severely ill individuals requiring detoxification or residential treatment, little empirical information is available about rates and predictors of subsequent engagement in necessary subsequent treatment. METHODS: Using administrative data from the largest Medicaid managed behavioral health organization in a large mid-Atlantic state, we used multivariate regression to examine rates and predictors of subsequent treatment engagement and retention following new episodes of detoxification or residential substance abuse treatment among 5670 Medicaid-enrolled adults during 2004-2006. RESULTS: Slightly less than half (49%) of the sample received follow-up care within 30 days of discharge. Rates of follow-up were significantly higher in individuals with a serious mental illness, and significantly lower in African-American individuals, males, individuals with disabilities, and those who received detoxification without residential treatment. The mean duration of follow-up treatment was 84 days, and was longer among individuals with a serious mental illness and Caucasians. Even after controlling for individuals' sociodemographic and clinical characteristics, there was substantial variation in follow-up rates among discharging providers. CONCLUSION: The relatively low rates of follow-up care and relatively brief duration of treatment for many of those who received such follow-up care are concerning in a population receiving substance abuse detoxification or residential treatment. The markedly lower rates among those receiving detoxification alone without subsequent residential treatment and among those without a comorbid serious mental illness suggest that efforts specifically targeting those individuals may be of particular benefit.
Authors: Victor A Capoccia; Frances Cotter; David H Gustafson; Elaine F Cassidy; James H Ford; Lynn Madden; Betta H Owens; Scott O Farnum; Dennis McCarty; Todd Molfenter Journal: Jt Comm J Qual Patient Saf Date: 2007-02
Authors: Dennis McCarty; David H Gustafson; Jennifer P Wisdom; Jay Ford; Dongseok Choi; Todd Molfenter; Victor Capoccia; Frances Cotter Journal: Drug Alcohol Depend Date: 2006-11-28 Impact factor: 4.492
Authors: Kim A Hoffman; James H Ford; Dongseok Choi; David H Gustafson; Dennis McCarty Journal: Drug Alcohol Depend Date: 2008-06-18 Impact factor: 4.492
Authors: Margaret T Lee; Constance M Horgan; Deborah W Garnick; Andrea Acevedo; Lee Panas; Grant A Ritter; Robert Dunigan; Hermik Babakhanlou-Chase; Alfred Bidorini; Kevin Campbell; Karin Haberlin; Alice Huber; Dawn Lambert-Wacey; Tracy Leeper; Mark Reynolds Journal: J Subst Abuse Treat Date: 2014-05-02