Scholarlink

Background <p>Addiction consult services (ACSs) are a growing hospital-based care model that increases quality of care for patients with substance use disorders (SUDs). One implementation barrier has been concern about negative financial impacts for health systems.</p> Objective <p>To examine whether starting an ACS changes hospital length-of-stay and 30-day readmissions for patients with opioid use disorder (OUD) served in a large academic health system.</p> Design <p>Quasi-experimental difference-in-differences study of opioid-related hospital admissions from January 2018 to December 2024, comparing one hospital that implemented an ACS to three hospitals in the same urban, academic system in Philadelphia, PA without ACSs.</p> Participants <p>Adults (≥ 18&#xa0;years) with opioid-related hospitalizations.</p> Intervention <p>A fully staffed, hospital-based, multidisciplinary ACS launched in July 2023.</p> Main Measures <p>Primary outcomes were hospital length-of-stay and 30-day readmissions. Secondary outcomes were receipt of any medication for opioid use disorder (MOUD) during hospitalization, discharge on a therapeutic MOUD dose, emergency department visits within 6&#xa0;months of discharge, and discharges before medically advised.</p> Key Results <p>In unadjusted analyses, ACS implementation was associated with a 5 percentage point increase in MOUD receipt (95% CI 0–10) and a 9 percentage point increase in discharge on therapeutic MOUD (95% CI 5–13), without significant changes in length-of-stay or 30-day readmissions. In adjusted analyses, therapeutic MOUD at discharge increased by 8 percentage points (95% CI 4–12), with no significant differences in length-of-stay or 30-day readmission. Results were robust to sensitivity analyses with alternative comparison groups and after accounting for the COVID-19 pandemic.</p> Conclusions <p>Implementation of an ACS improved evidence-based care for hospitalized patients with OUD without prolonging length-of-stay or increasing readmissions.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Association Between Hospital-Based Addiction Consult Service Implementation and Hospital Length-of-Stay and 30-Day Readmission Rates for Patients with Opioid Use Disorder

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月29日

查看全文
  • Margaret Lowenstein,
  • Seiyoun Kim,
  • Suzy Landon,
  • Lin Xu,
  • David S. Mandell,
  • Jeanmarie Perrone,
  • Paula Chatterjee

摘要

Background

Addiction consult services (ACSs) are a growing hospital-based care model that increases quality of care for patients with substance use disorders (SUDs). One implementation barrier has been concern about negative financial impacts for health systems.

Objective

To examine whether starting an ACS changes hospital length-of-stay and 30-day readmissions for patients with opioid use disorder (OUD) served in a large academic health system.

Design

Quasi-experimental difference-in-differences study of opioid-related hospital admissions from January 2018 to December 2024, comparing one hospital that implemented an ACS to three hospitals in the same urban, academic system in Philadelphia, PA without ACSs.

Participants

Adults (≥ 18 years) with opioid-related hospitalizations.

Intervention

A fully staffed, hospital-based, multidisciplinary ACS launched in July 2023.

Main Measures

Primary outcomes were hospital length-of-stay and 30-day readmissions. Secondary outcomes were receipt of any medication for opioid use disorder (MOUD) during hospitalization, discharge on a therapeutic MOUD dose, emergency department visits within 6 months of discharge, and discharges before medically advised.

Key Results

In unadjusted analyses, ACS implementation was associated with a 5 percentage point increase in MOUD receipt (95% CI 0–10) and a 9 percentage point increase in discharge on therapeutic MOUD (95% CI 5–13), without significant changes in length-of-stay or 30-day readmissions. In adjusted analyses, therapeutic MOUD at discharge increased by 8 percentage points (95% CI 4–12), with no significant differences in length-of-stay or 30-day readmission. Results were robust to sensitivity analyses with alternative comparison groups and after accounting for the COVID-19 pandemic.

Conclusions

Implementation of an ACS improved evidence-based care for hospitalized patients with OUD without prolonging length-of-stay or increasing readmissions.

Graphical Abstract