During hospitalization for medical conditions related to substance use (e.g., abscess, endocarditis), the underlying substance use is rarely addressed, and post-discharge referral for substance use treatment often goes uncompleted. Consequently, frequent readmissions and deterioration in health status are common.

In an attempt to break this cycle, researchers evaluated the impact of a special 12-bed unit in an inpatient day hospital (DH) that addressed patients’ medical as well as substance-use treatment needs. Patients were assigned to DH (n=63) or usual care (n=327) based on the availability of beds. Patients predominately used heroin (77%) or cocaine (66%), and the majority (69%) were unemployed.

• Forty-nine percent of patients assigned to DH completed the 2-week program.
• In the 6 months following discharge, those patients who completed DH treatment were less likely than patients who received usual care to visit emergency departments and were more likely to have ≥1 ambulatory care visit. Hospital admissions did not differ significantly between the groups.
• Patients who were assigned to but did not complete the DH program demonstrated no post-discharge improvements in health service utilization.

Comments by Michael Boyle, MA
Addiction treatment providers could potentially increase engagement in substance abuse treatment through partnering with a hospital to develop integrated medical and substance-use care models. Having treatment resources readily available may encourage diagnosis and treatment referrals for persons with drug problems.  Reducing emergency department visits from uninsured individuals and increasing the use of ambulatory care may be an incentive for hospitals to pursue such collaborations.