OUTCOMES OF RESIDENTIAL-TREATMENT OF SUBSTANCE-ABUSE IN-HOSPITAL AND COMMUNITY-BASED PROGRAMS

Objective: The study sought to determine whether inpatient readmission rates differed for patients with substance use disorders who were tre ated in either hospital-based or community-based transitional resident ial care. Length of residential care and intensity of outpatient menta l health aftercare were examined as predictors of readmission. Methods : Department of Veterans Affairs nationwide databases were used to doc ument readmissions at one- and two-year intervals for male inpatients treated for substance use disorders who were discharged either to hosp ital-based (N=2,190) or community-based (N=4,490) residential care. Pa tients with and without concomitant psychiatric diagnoses were identif ied. Results: Patients treated in community-based residential programs had lower one- and two-year readmission rates than patients who recei ved hospital-based residential care. Longer episodes of residential ca re and more outpatient mental health care were also associated with lo wer readmission rates. Among patients with concomitant psychiatric dis orders, those in hospital-based care benefited more from longer episod es of residential care and more intensive outpatient mental health aft ercare. Residential care, longer episodes of care, and more outpatient mental health care were independent predictors of lower one- and two- year readmission rates after patient-based risk factors were controlle d, Conclusions: The findings highlight the value of providing adequate amounts of residential and outpatient care for patients in substance abuse treatment, especially patients with concomitant psychiatric diso rders.