The hospital admission profile of people presenting to specialist addiction services with problematic use of alcohol or opioids: A national retrospective cohort study in England

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dc.contributor.authorRoberts, E.
dc.contributor.authorHotopf, M.
dc.contributor.authorStrang, J.
dc.contributor.authorMarsden, J.
dc.contributor.authorWhite, M.
dc.contributor.authorEastwood, B.
dc.contributor.authorDrummond, C.
dc.date.issued2021
dc.description.abstractBackground: Over the past decade in England the rate of alcohol and opioid-related hospitalisation has increased alongside a simultaneous reduction in people accessing specialist addiction treatment. We aimed to determine the hospitalisation patterns of people presenting to addiction treatment with problematic use of alcohol or opioids, and estimate how individual sociodemographic characteristics and hospital admission diagnoses are associated with the rate of hospitalisation, death and successful completion of addiction treatment. Methods: A national record linkage between Hospital Episode Statistics (HES) and the National Drug Treatment Monitoring System (NDTMS) captured lifetime hospital admission profiles of people presenting to addiction services in England in 2018/19. Latent class analysis assigned individuals to clusters based on the ICD-10 diagnosis coded as primary reason for admission. Negative binomial, and multilevel logistic regression models determined if outcomes differed due to sociodemographic characteristics or assigned diagnostic clusters. Findings: Inpatient data were available for 64,840 alcohol patients, and 107,296 opioid patients. The most common reasons for admission were alcohol withdrawal (n = 20,024 (5.3% of alcohol-cohort admissions)), and unspecified illness (n = 11,387 (2.1% of opioid-cohort admissions)). Seven diagnostic clusters were identified for each substance cohort. People with admissions predominantly relating to mental and behavioural disorders, and injuries or poisonings had significantly higher hospitalisation rates (adjusted IRR 7.06 (95%CI 6.72 7.42);p < 0.001), higher odds of death during addiction treatment (adjusted OR 2.71 (95%CI 2.29 3.20);p < 0.001) and lower odds of successful treatment completion (adjusted OR 0.72 (95%CI 0.68 0.76);p < 0.001). Interpretation: This is the first study to interrogate national hospitalisation patterns within people presenting to addiction services with problematic use of alcohol or opioids. Having identified high-risk, high-cost individuals with increased hospital usage, and increased odds of death, future work should focus on targeting appropriate interventions, to improve their health outcomes and prevent unnecessary hospital readmission.
dc.description.statementofresponsibilityEmmert Roberts, Matthew Hotopf, John Strang, John Marsden, Martin White, Brian Eastwood, Colin Drummond
dc.identifier.citationThe Lancet Regional Health. Europe, 2021; 3:100036-1-100036-12
dc.identifier.doi10.1016/j.lanepe.2021.100036
dc.identifier.issn2666-7762
dc.identifier.issn2666-7762
dc.identifier.orcidMarsden, J. [0000-0002-1307-2498]
dc.identifier.urihttps://hdl.handle.net/2440/140098
dc.language.isoen
dc.publisherElsevier
dc.rights© 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
dc.source.urihttps://doi.org/10.1016/j.lanepe.2021.100036
dc.subjectalcohol and opioid-related hospitalisation
dc.titleThe hospital admission profile of people presenting to specialist addiction services with problematic use of alcohol or opioids: A national retrospective cohort study in England
dc.typeJournal article
pubs.publication-statusPublished

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