Length of hospitalization and hospital readmissions among patients with substance use disorders in New York City, NY USA

Abstract

IntroductionIn the United States, the number of patients with substance use disorders is steadily increasing. Individuals with a substance use disorder may be more likely to experience negative hospital outcomes, including lengthier hospital stays and frequent readmissions, which is extremely costly to patients and to the government. While there are established associations between substance use disorder and hospital readmissions, the impact of substance use disorder on other outcomes such as length of stay remain unclear. We assessed whether hospital admissions diagnosed with substance use disorders experienced longer hospital stays and readmissions compared to patients without a substance use disorder diagnosis. MethodsThis is a retrospective study of hospital readmissions rates in three hospitals in the New York City, New York area. Data were examined over a 10-year period (from 2007 to 2016, n = 768,219). We used multilevel multivariable regression models to compare the hospital length of stay, time-to-hospital readmission, and 30-day hospital readmission among admissions with substance use disorder compared to admissions without the disorder. ResultsAs compared to those who did not have a substance use disorder, admissions with substance use disorder had longer hospital length of stay (Regression coefficient (b) = 1.24; 95% CI: 1.15–1.33), were more likely to experience hospital readmission at any point in time (HR = 1.24; 95 % CI: 1.22–1.25), and were more likely to have a 30-day hospital readmission (RR = 1.16; 95 % CI: 1.13–1.19). ConclusionsHospital settings could potentially serve as useful venues for substance use-related interventions and could benefit from strong coordination with outpatient providers and more targeted discharge planning.