R H Moos1, B Pettit, V Gruber. 1. Program Evaluation and Resource Center, Department of Veterans Affairs Medical Center, Palo Alto, California 94304, USA.
Abstract
OBJECTIVE: The study focuses on whether substance abuse patients who enter a community residential facility (CRF) after discharge from inpatient care obtain more outpatient mental health care and have lower readmission rates than comparable patients discharged directly to the community. METHOD: A national sample of substance abuse patients (N = 5,176; 99% men) referred to CRFs after inpatient substance abuse care is compared to a matched sample of patients (N = 5,176; 99% men) discharged to the community. RESULTS: Compared with controls, CRF patients were more likely to obtain outpatient mental health aftercare and obtained more intensive care. Patients with longer episodes of CRF care had lower 6-month and 1-year readmission rates than patients who dropped out of CRFs and than matched controls. These findings held for patients who had only alcohol diagnoses, patients who had drug diagnoses and patients who had psychiatric diagnoses in addition to their substance abuse disorders. Longer length of CRF care and more outpatient mental health care were significant predictors of lower readmission rates after other risk factors for readmission were controlled. CONCLUSIONS: Longer episodes of community residential care can contribute to better outcomes for substance abuse patients, in part by maintaining patients' involvement in outpatient mental health care. CRFs may play an important role in the continuum of substance abuse patients' care.
OBJECTIVE: The study focuses on whether substance abusepatients who enter a community residential facility (CRF) after discharge from inpatient care obtain more outpatient mental health care and have lower readmission rates than comparable patients discharged directly to the community. METHOD: A national sample of substance abusepatients (N = 5,176; 99% men) referred to CRFs after inpatient substance abuse care is compared to a matched sample of patients (N = 5,176; 99% men) discharged to the community. RESULTS: Compared with controls, CRF patients were more likely to obtain outpatient mental health aftercare and obtained more intensive care. Patients with longer episodes of CRF care had lower 6-month and 1-year readmission rates than patients who dropped out of CRFs and than matched controls. These findings held for patients who had only alcohol diagnoses, patients who had drug diagnoses and patients who had psychiatric diagnoses in addition to their substance abuse disorders. Longer length of CRF care and more outpatient mental health care were significant predictors of lower readmission rates after other risk factors for readmission were controlled. CONCLUSIONS: Longer episodes of community residential care can contribute to better outcomes for substance abusepatients, in part by maintaining patients' involvement in outpatient mental health care. CRFs may play an important role in the continuum of substance abusepatients' care.
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