Effect of residential versus ambulatory treatment for substance use disorders on readmission risk in a register-based national retrospective cohort

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dc.coverageDOI: 10.1007/s00127-025-02865-9
dc.creatorGonzález-Santa Cruz, Andrés
dc.creatorMauro, Pia M.
dc.creatorSapag, Jaime C.
dc.creatorMartins, Silvia S.
dc.creatorRuiz-Tagle, José
dc.creatorGaete, Jorge
dc.creatorCerdá, Magdalena
dc.creatorCastillo-Carniglia, Alvaro
dc.date2025
dc.date.accessioned05-01-2026 18:07
dc.date.available05-01-2026 18:07
dc.description<p>Purpose: In this article, we studied whether pathways in substance use disorder (SUD) treatment differ among people admitted to residential versus ambulatory settings. Methods: We analyzed a retrospective cohort of 84,755 adults (ages ? 18) in Chilean SUD treatment during 2010–2019, creating a comparable sample of 11,226 pairs in ambulatory and residential treatment through cardinality matching. We used a nine-state multistate model, stratifying readmissions by baseline treatment outcome (i.e., completion vs. noncompletion) from admission to the third readmission. We estimated transition probabilities and lengths of stay in states at three-month, one-year, three-year, and five-year follow-ups. Sensitivity analyses tested different model specifications and estimated E-values. Results: Patients in residential settings (vs. ambulatory) had greater treatment completion probabilities (difference at three months; 3.4% [95% CI: 2.9%, 3.9%]), and longer treatment retention (e.g., 1.6 days longer at three months, 95% CI: 0.8, 2.3). Patients in residential vs. ambulatory settings had higher first readmission probabilities regardless of baseline treatment outcome (e.g., three-month difference: 5.7% if completed baseline [95% CI: 4.4%, 7.0%] and 8.0% if did not complete baseline [95% CI: 6.7, 9.3%]). Third readmission probabilities were higher only among patients in residential settings with an incomplete baseline treatment (at least 3.7%; 95% CI: 0.2%, 7.3% at 1-year). Conclusion: Patients in residential settings at baseline were more likely to experience a second treatment and a third readmission among patients with incomplete treatments. Findings underscore the importance of completing initial SUD treatments to reduce readmissions. Residential treatments might require additional strategies to prevent readmissions.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/82e480d6-5605-48d7-956c-7e5fabaa1a7d
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.60 (2025) nr.9 p.2107-2123
dc.subjectAmbulatory care
dc.subjectChile
dc.subjectResidential treatment
dc.subjectSubstance use disorders
dc.subjectTreatment
dc.subjectSDG 3 - Good Health and Well-being
dc.titleEffect of residential versus ambulatory treatment for substance use disorders on readmission risk in a register-based national retrospective cohorteng
dc.typeArticleeng
dc.typeArtículospa
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