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Patient Navigation Services Cut Readmission in Adults With SUD

TUESDAY, April 6, 2021 -- For hospitalized adults with comorbid substance use disorders (SUDs), patient navigation services reduce readmissions and emergency department use, according to a study published online April 6 in the Annals of Internal Medicine.

Jan Gryczynski, Ph.D., from the Friends Research Institute in Baltimore, and colleagues examined whether patient navigation services reduce hospital readmissions in a randomized trial involving 400 hospitalized adults with comorbid SUDs. Participants were randomly assigned to receive either treatment as usual (TAU) or Navigation Services to Avoid Rehospitalization (NavSTAR), which uses proactive case management, advocacy, service linkage, and motivational support to resolve internal and external barriers to care and address needs for three months after discharge.

The researchers found that participants had high levels of acute care use: 69 and 79 percent had an inpatient readmission and visited the emergency department, respectively, during the 12-month observation period. Per 1,000 person-years, event rates were 6.05 and 8.13 for NavSTAR and TAU, respectively, for inpatient admissions (hazard ratio, 0.74) and 17.66 and 27.85, respectively, for emergency department visits (hazard ratio, 0.66). The likelihood of having an inpatient readmission within 30 days was reduced for participants in the NavSTAR group versus the TAU group (15.5 versus 30.0 percent), and the likelihood of entering community SUD treatment after discharge was increased (50.3 versus 35.3 percent for treatment entry within three months).

"Proactive, personalized patient navigation services for hospital patients with comorbid SUDs were effective in reducing hospital readmissions and emergency department visits over a 12-month observation period," the authors write. "These findings have important implications for patient care and service organization in hospitals concerned with reducing readmissions."

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