Veterans' Service Utilization Patterns After Alcohol and Opioid Detoxification in VHA Care
OBJECTIVE:
This
study aimed to examine detoxification-related service utilization in the
Veterans Health Administration (VHA).
METHODS:
VHA data
for 266,908 patients were used to examine rates and predictors of receiving
detoxification, attending post-detoxification appointments, and entering
specialty treatment. Multilevel, mixed-effects logistic regressions were used
to examine associations between patient and facility characteristics and
service utilization.
RESULTS:
Nationally,
8.0% of VHA patients with alcohol or opiate dependence received detoxification
in fiscal year 2013 (facility range=.1%-20.4%); 43.1% of detoxified patients
received follow-up (11.1%-76.4%), and 49.9% entered specialty treatment
(13.0%-77.2%). In adjusted analyses, detoxification was more likely among male,
younger, white, and homeless patients
with documented alcohol or opiate disorders and comorbid general medical
conditions but without previous addiction treatment. Detoxification was also
more likely in facilities with fewer vacant addiction therapist positions.
Follow-up and specialty treatments were more likely among younger, healthier homeless patients with previous addiction treatment and
a documented alcohol use disorder.
CONCLUSIONS:
Detoxification-related
service utilization was highly variable across the VHA. Interventions are
needed to optimize use.
- 1The authors are with Health Services Research and Development (HSR&D), U.S. Department of Veterans Affairs, Menlo Park, California (e-mail: christine.timko@va.gov ).
- Psychiatr Serv. 2016 Jan 14:appips201400579.
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