Factors Associated with Seeking Readmission Among Clients Admitted to Medical Withdrawal Management

ABSTRACT

The objectives of the present paper were to determine the rate and factors associated with seeking readmission among the clients admitted to an inpatient medical withdrawal management program, Vancouver Detox (VD). All clients who were admitted to VD between July 1, 2003, and June 30, 2004, were included in the study, and were followed up for 1 year. Multinomial logistic regression was performed to investigate the potential risk factors associated with short-term (1 month) and long-term (2 to 12 months) requests for readmission simultaneously. The risk factor associated with short-term request for readmission was leaving VD against medical advice (AMA) during the index admission. Clients who reported to have hepatitis C virus (HCV) infection, whose primary preferred substance was alcohol, and those who were poly-drug users were more likely to request readmission in long-term. Clients with no fixed address were less likely to seek readmission between months 2 and 12.

KEYWORDS:

• Detoxification
• requests for readmission
• substance use disorders
• withdrawal management

Xin Li holds a postdoctoral fellowship from the Michael Smith Foundation for Health Research. The authors would like to gratefully acknowledge the staffs at ACCESS 1 and Vancouver Detox for their administrative support and helpful comments. In particular, John Collens and Mary Marlow deserve special mention

Notes

∗Two-category variable (aboriginal/other).

∗∗Referral sources (self-referred/other).

^†Cocaine group includes cocaine, crack cocaine; opiates group includes heroin, methadone, oxycodone, other opiates.

^‡Defined as clients having methadone maintenance therapy at referral.

∗The reference group is no request group during 1-year follow-up. Short term is defined as request for readmission within 1 month; long term is defined as request for readmission between 2 and 12 months.

^†Statistically significant at P <.05.