Predictors of Five-year Readmission to an Inpatient Service among Patients with Opioid Use Disorders

Abstract

ABSTRACT Background Opioid use disorder (OUD), a relapsing-remitting chronic medical disease, accounts for a sizable proportion of all-cause adult inpatient stays. We evaluated the incidence and predictors of any and multiple readmissions to inpatient care for OUD. Methods This retrospective, register-based cohort study assessed consecutive patients with OUD admitted to a federally-funded inpatient service of an addiction treatment center in North India between January 2007 and December 2014. Binary logistic regression was used to determine independent readmission predictors based on demographic, clinical, and treatment variables that significantly differed in bivariate analysis. Results Among 908 patients, 306 (33.7%) and 106 (11.7%) had any and multiple readmissions, respectively. Injection drug use (Odds ratio [OR] 2.92, 95% confidence interval [CI] 1.90–4.49), comorbid severe mental illness (OR 2.80, 95% CI 1.42–5.55) and common mental disorder (OR 3.4 95% CI 1.65–6.95), antagonist treatment (OR 1.6 95% CI 1.14–2.27), and urban residence (OR 1.38 95% CI 1.01–1.90) increased odds of readmission. ‘Improved’ discharge status (OR 0.48 95% CI 0.34–0.70) in first admissions reduced odds of any readmission. Similar risk factors also influenced multiple readmissions with higher odds ratios. Conclusions Identification and adequate treatment of risk factors may reduce the chances of readmission.