Journal
DRUG AND ALCOHOL DEPENDENCE
Volume 140, Issue -, Pages 168-174Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2014.04.018
Keywords
Readmission; Detoxification; Substance abuse treatment; Alaska Native People; American Indian
Categories
Funding
- National Institute for Minority Health and Health Disparities [P60 MD000507]
- NIH/NCATS Colorado CTSI [UL1 TR000154]
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Background: This study examined predictors associated with readmission to detoxification in a sample of adult Alaska Native patients admitted to inpatient alcohol detoxification. Even though Alaska Native people diagnosed with alcoholism have been identified as frequent utilizers of the health care system and at elevated risk of death, little is known about factors associated with readmission to detoxification for this group. Methods: We sought to predict readmission using a retrospective cohort study. The sample included 383 adult Alaska Native patients admitted to an inpatient detoxification unit and diagnosed with alcohol withdrawal during 2006 and 2007. Cox proportional hazard modeling was used to estimate unadjusted and adjusted associations with time to readmission within one year. Results: Forty-two percent of the patients were readmitted within one year. Global Assessment Functioning (GAF; Axis V in the multi-axial diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders [DSM IV]) score measured at the time of intake was associated with readmission. A one point increase in the GAF score (HR=.96,95% CL=.94,.99, P=.002) was associated with a four percent decrease in readmission. The results also indicated that the GAF mediated the relationship between readmission and: employment and housing status. Conclusions: The GAF measures both illness severity and adaptive functioning, is part of standard behavioral health assessments, and is easy to score. Readmission rates potentially could be decreased by creating clinical protocols that account for differences in adaptive functioning and illness severity during detoxification treatment and aftercare. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
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