Interprofessional Hospital Addiction Consults Are Associated with Decreased Patient-Directed Discharges.

Area of Science:

• Addiction Medicine
• Hospital Medicine
• Public Health

Background:

• Hospitalizations for substance use disorder (SUD) are rising.
• Patient-directed discharge (PDD) occurs in up to 30% of these cases, leading to poor outcomes.
• The impact of addiction consult services (ACS) on PDD is not well understood.

Purpose of the Study:

• To investigate the association between receiving ACS and the likelihood of PDD in hospitalized patients with SUD.
• To analyze the impact of different ACS team members on PDD rates.

Main Methods:

• Retrospective cohort study conducted at an urban academic hospital.
• Included patients with an ICD-10 diagnosis of SUD between 2018 and 2022.
• Analyzed receipt of ACS, including consults by addiction medicine providers (AMP), behavioral health social workers (BHSW), and peers, to determine odds of PDD.

Main Results:

• Receipt of ACS was linked to a significant decrease in the odds of PDD (aOR 0.81).
• Patients seen by BHSW only (aOR 0.61), peer only (aOR 0.49), and both AMP and peer (aOR 0.71) had significantly lower odds of PDD compared to those not seen by ACS.
• Over 16,000 hospitalizations were analyzed, with over 3,400 completed consults.

Conclusions:

• Addiction consult services are associated with reduced PDD rates in hospitalized patients with SUD.
• Further research is needed to optimize ACS team composition and utilization for improved patient care.