Substance use treatment barriers for patients with frequent hospital admissions

Maria C. Raven, Emily R. Carrier, Joshua Lee, John C. Billings, Mollie Marr, Marc N. Gourevitch

Research output: Contribution to journalArticle

Abstract

Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identified by a validated statistical algorithm as being at high-risk for frequent hospitalizations were interviewed at an urban public hospital. Patient drug/alcohol history, experiences with medical, psychiatric and addiction treatment, and social factors contributing to readmission were evaluated. Three themes related to SU and frequent hospitalizations emerged: (a) barriers during hospitalization to planning long-term treatment and follow-up, (b) use of the hospital as a temporary solution to housing/family problems, and (c) unsuccessful SU aftercare following discharge. These data indicate that homelessness, brief lengths of stay complicating discharge planning, patient ambivalence regarding long-term treatment, and inadequate detox-to-rehab transfer resources compromise substance-using patients' likelihood of avoiding repeat hospitalization. Intervention targets included supportive housing, detox-to-rehab transportation, and postdischarge patient support.

Original languageEnglish (US)
Pages (from-to)22-30
Number of pages9
JournalJournal of Substance Abuse Treatment
Volume38
Issue number1
DOIs
StatePublished - Jan 2010

Keywords

  • Frequent hospitalization
  • High risk
  • Homelessness
  • Medicaid
  • Substance use
  • Treatment barriers

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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