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Published Online: 14 January 2016

Veterans’ Service Utilization Patterns After Alcohol and Opioid Detoxification in VHA Care

Abstract

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.

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Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Fame Weathervane, by E.G. Washburne and Company, circa 1890. Copper and zinc with gold leaf. American Folk Art Museum, Long Island City, New York. Gift of Ralph Esmerian, accession number 2005.8.62. Photo credit: Gavin Ashworth.

Psychiatric Services
Pages: 460 - 464
PubMed: 26766752

History

Received: 21 December 2014
Revision received: 18 June 2015
Accepted: 15 July 2015
Published online: 14 January 2016
Published in print: April 01, 2016

Authors

Details

Christine Timko, Ph.D.
The authors are with Health Services Research and Development (HSR&D), U.S. Department of Veterans Affairs, Menlo Park, California (e-mail: [email protected]).
Shalini Gupta, M.S.
The authors are with Health Services Research and Development (HSR&D), U.S. Department of Veterans Affairs, Menlo Park, California (e-mail: [email protected]).
Nicole Schultz, M.A.
The authors are with Health Services Research and Development (HSR&D), U.S. Department of Veterans Affairs, Menlo Park, California (e-mail: [email protected]).
Alex H. S. Harris, Ph.D.
The authors are with Health Services Research and Development (HSR&D), U.S. Department of Veterans Affairs, Menlo Park, California (e-mail: [email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

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