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Lotchin T, Gardner J, Hendricks A, MacDonald J. Intensity of follow-up care to inpatient detoxification: The relative impact of domiciliary care in Veterans' Health Administration. Bedford, MA: HCFE; 2004 Mar 31. 1-22 p. Report No.: HCFE Working Paper No. 2004-04.
OBJECTIVES: To quantify the impact of resource-intensive treatment programs on veterans' healthcare utilization following inpatient detoxification. METHODS: All veterans receiving inpatient detoxification in a Veterans' Administration (VA) Medical Center during FY1998 were grouped based on the follow-up care they received. Healthcare utilization was characterized using administrative databases and a standard survival analysis. RESULTS: Veterans discharged from the VA who received follow-up care through a domiciliary program were significantly less likely to be rehospitalized in the VA within 12 months of their domiciliary discharge than veterans receiving only outpatient follow-up care following their detoxification discharge. Almost two-thirds (63.7%) of veterans receiving outpatient follow-up had an inpatient admission in the 12 months following detoxification compared to 57.1% of veterans who received care in a domiciliary. Further, remaining in the domiciliary programs more than 3 to 4 months approximately doubled the likelihood that the patient would not be rehospitalized, controlling for population characteristics. CONCLUSIONS: The VA's domiciliary follow-up program extends the period of time to an acute hospitalization not only for the time of the domiciliary stay itself but also following discharge. A longer follow-up period is needed to capture the pattern of hospitalizations for veterans receiving domiciliary care.
