Addiction Consultation Service: Effects on Return Visits to the Emergency Department

Introduction The Addiction Consultation Service of Hershey Medical Center offers assessment, treatment and outpatient resources to patients diagnosed with a substance use disorder. This study aims to evaluate the efficacy of this program in connecting patients to resources and to compare rates of return to the Emergency Department (ED) within 90 days of discharge between those consenting versus declining an addiction consult. Methods The Addiction Consult Service's database was used to identify all patients who were evaluated between February 2023 and September 2023 for substance-related concerns in the ED. Results For the study, 258 eligible subjects were identified. The majority of patients (n=167/258, 65.3%) were admitted to inpatient hospital services, 21.8% (n=56/258) were discharged and 8.2% (n=21/258) were transferred to an inpatient drug and alcohol rehabilitation facility. Of them, 202/227 (89.0%) patients received a consultation from the Addiction Consult Service, and 25/227 (11.0%) received a consultation from another service. Of these patients, the majority consented to the treatment plan suggested by the Addiction Consult Service (n=148/202, 73.3%). Patients who consented to the treatment plan were less likely to return to the ED for substance use concerns within 30 days of discharge, compared to those who declined a consultation (X ²(2, N=202)=24.1, p<0.0001). This finding was not significant within 30-90 days of discharge (X ²(2, N=202)=4.5, p=0.1043). Conclusions Receiving an in-hospital consultation from an addiction specialty service was associated with fewer repeat ED visits related to substance use disorder within 30 days of discharge. Targeted follow-up and comprehensive treatment plans are likely needed to reduce repeat ED visits.