Care pathways to in‐patient alcohol detoxification and their effects on predictors of treatment completion

Abstract

Aims: This study aimed to (i) test the hypothesis that stable housing, older age, gate‐kept admission route and female gender are predictive of completion of in‐patient detoxification treatment, and (ii) compare two care pathways into treatment.

Methods: Multiple logistic regression of 6,745 cases of admission to an independent sector in‐patient detoxification service between January 1995 and March 2003.

Findings: Factors predictive of treatment completion were found to be older age, female gender, employment and undergoing a process of gate‐keeping for admission. A comparison of treatment completers between gate‐kept and non‐gate‐kept admissions indicated that while gate‐keeping is sensitive to potential completers by favouring people with stable housing it may also be excluding a proportion of clients among younger males with unstable housing who would otherwise benefit from admission.

Conclusions: In developing care pathways that ensure effective and appropriate use of services careful consideration must be given to the impacts upon some client groups who may be disadvantaged by the process.

• Access to treatment
• service development
• targeting need
• treatment completion
• whole systems

Acknowledgement

A grant of £10,000 was provided by Turning Point to produce a report on the use of the Smithfield Project detoxification service for internal use within the organization. The data from this work has been used to produce this paper.