Predictors for 30-Day and 90-Day Hospital Readmission Among Patients With Opioid Use Disorder. Issue 4 (July 2019)

• Record Type: Journal Article
• Authors: Moreno, Jessica L.; Wakeman, Sarah E.; Duprey, Matthew S.; Roberts, Russell J.; Jacobson, Jared S.; Devlin, John W.
• Is Part Of: Journal of addiction medicine. Volume 13:Issue 4(2019)
• Publication Date: 2019-07
• Subjects: buprenorphine -- opioid agonist treatment -- opioid use disorder -- opioids -- readmission; Substance abuse -- Periodicals; Substance abuse -- Treatment -- Periodicals; Substance-Related Disorders -- Periodicals; 616.86005
• DOI: 10.1097/ADM.0000000000000499
• Languages: English
• ISSNs: 1932-0620

Abstract

Abstract : Objectives: To identify the incidence, characteristics, and predictors for 30 and 90-day readmission among acutely hospitalized patients with opioid use disorder (OUD). Methods: This retrospective, cohort study evaluated consecutive adults with OUD admitted to an academic medical center over a 5-year period (10/1/11 to 9/30/16). Multivariable logistic regression was used to determine independent predictors for 30 and 90-day readmissions based on pertinent admission, hospital, and discharge variables collected via chart review and found to be different (with a P < 0.10) on univariate analysis. Results: Among the 470 adults (mean age 43.1 ± 12.8 years, past heroin use 77.9%; admission opioid agonist therapy use [buprenorphine 22.6%; methadone 27.0%]; medical [vs surgical] admission 75.3%, floor [vs ICU] admission 93.0%, in-hospital mortality 0.9%), 85 (18.2%) and 151 (32.1%) were readmitted within 30 and 90 days, respectively. Among the 90-day readmitted patients, median time to first readmission was 26 days. Buprenorphine use (vs no use) at index hospital admission was independently associated with reduced 30-day (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.24–0.93) and 90-day (OR 0.57, 95% CI 0.34–0.96) readmission; prior heroin (vs prescription opioid) use was associated with reduced 90-day readmission (OR 0.59, 95% CI 0.37–0.94) and length of hospital stay was associated with both greater 30-day (OR 1.02, 95% CI 1.01–1.05) and 90-day (OR 1.04, 95% CI 1.01–1.06) readmission rates. Conclusions: Among patients with OUD taking buprenorphine at the time of hospital admission, 30-day and 90-day hospital readmission was reduced by 53% and 43%, respectively.