PROGRAM CHARACTERISTICS AND READMISSION AMONG OLDER SUBSTANCE-ABUSE PATIENTS - COMPARISONS WITH MIDDLE-AGED AND YOUNGER PATIENTS

Older substance abuse patients were compared to middle-aged and younge r patients before, during, and after an index episode of inpatient car e in I of 88 substance abuse treatment programs. Associations between program characteristics and readmission rates adjusted for key differe nces in The types of patients in different programs varied by age grou p. Among older patients, more structured program policies, more flexib le rules about discharge, more comprehensive assessment, and more outp atient mental health aftercare were associated with lower casemix-adju sted readmission rates. More intensive treatment was associated with h igher-than-predicted readmission. By contrast, among younger-patients, more family involvement in assessment and treatment, community consul tation and treatment emphasizing the development of social and work sk ills were associated with lower casemix-adjusted readmission rates. Th e findings suggest that intensive, directed treatment may be more effe ctive for younger substance abuse patients, whereas a more supportive treatment regimen in a well-organized program and prompt outpatient af tercare may be especially helpful for older patients.