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J Addict Med. 2019 Jul/Aug;13(4):306-313. doi: 10.1097/ADM.0000000000000499.

Predictors for 30-Day and 90-Day Hospital Readmission Among Patients With Opioid Use Disorder.

Author information

1
Department of Quality Management and Patient Safety, Beaumont Health, Southfield, MI (JLM); Substance Use Disorders Initiative, Massachusetts General Hospital and Department of Medicine, Harvard Medical School, Boston, MA (SEW); School of Pharmacy, Northeastern University, Boston, MA (MSD); Department of Pharmacy, Massachusetts General Hospital, Boston, MA (RJR); Department of Health Sciences, Northeastern University, Boston, MA (JSJ); School of Pharmacy, Northeastern University, Boston, MA (JWD).

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.

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