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Utilization of outpatient mental health services after inpatient alcoholism treatment
Authors:Dr. Brenda M. Booth Ph.D.  Cynthia A. Loveland Cook Ph.D.  Frederic C. Blow Ph.D.  Janice Y. Bunn M.S.
Affiliation:1. Health Services Research (152), VA Medical Center, 52246, Iowa City, IA
2. Graduate Program in Hospital and health Administration and Center for Health Services Research, University of Iowa, USA
3. George Warren Brown School of Social Work, Washington University, Washington, USA
4. Alcohol Research Center, University of Michigan, USA
5. Health Services Research, VA Medical Center, Iowa City, USA
Abstract:It is generally agreed that use of aftercare services following discharge from alcoholism treatment is optimum for patients to achieve long-term recovery. However, the quantity and duration of utilization of such services in non-experimental settings are generally unknown. Using secondary data sources, we studied 5,635 alcoholics completing formal extended inpatient treatment and 1,860 alcoholics discharged from brief inpatient hospitalizations in Department of Veterans Affairs medical centers. Weekly use of outpatient mental health services (OPMH) prior to hospital admission was equally low for both patient groups (approximately 2–3% of patients) until four weeks prior to admission, at which time OPMH use increased, particularly for the extended treatment group. In the four weeks after discharge, use of OPMH services was substantially higher for patients with extended treatment compared to those with brief hospitalizations (40% vs. 18%), with 22% of patients completing treatment utilizing such services in the first week after discharge. Utilization steadily decreased until only 8% and 4% of both groups, respectively, were using OPMH services at the end of six months after discharge. Study results suggest the need to examine barriers to outpatient mental health utilization after discharge as well as interventions to increase compliance with long-term aftercare. This study was supported by grants R01-AA08732 (all authors) and P50-AA07378 (Dr. Blow) from the National Institute on Alcohol Abuse and Alcoholism.
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