Chapter 6

Discharge Data: 2001

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Reason for Discharge

Treatment Completion

Length of Stay

The goal of TEDS is to collect information on complete treatment episodes. Thus, SAMHSA has expanded its data collection efforts to include discharge data. States are asked to submit data for all discharges from substance abuse treatment. These data can be linked to admissions data, which enhances the analytic potential of the TEDS system.

A total of 22 States submitted discharge data for Year 2001; therefore, the data presented in this chapter do not represent all discharges in all States.

Items on the discharge record include:

Definitions and classifications are detailed in Appendix B.

For this chapter, each discharge record was linked to the original admission record. Type of service at admission and type of service at discharge were the same for all linked records. In the tables presented in this chapter, Type of service and Planned use of methadone have been combined to yield discrete service types. Records where the use of methadone was planned were classified as Methadone. Detoxification represents primarily free-standing residential detoxification (95 percent), but also includes ambulatory detoxification (3 percent) and hospital inpatient detoxification (2 percent).

Tables 6.1a and 6.1b present the distribution of key variables for all Year 2001 admissions, for Year 2001 admissions in the 22 States submitting discharge data, and for linked and non-linked Year 2001 discharge records in the 22 States. These tables indicate that characteristics at the time of admission for the discharges submitted by the 22 States are similar to the characteristics of all admissions in all States.

Almost half (43 percent) of all Year 2001 discharges reported primary alcohol abuse at admission. Seventeen percent of Year 2001 discharges were for opiate abuse at admission. Fifteen percent each of Year 2001 discharges were for abuse of marijuana and cocaine at admission. Stimulant abuse at admission accounted for 6 percent of all Year 2001 discharges.

Table 6.2. A total of 635,711 records for clients discharged in Year 2001 were submitted by 22 States. Eighty-seven percent of these records (n = 555,090) could be linked to a TEDS admission record from 1999, 2000, or 2001. An additional 267 methadone records were linked to an admission that occurred in 1998. No matching admission record was found for 80,354 of the Year 2001 discharges. As discharge records are added to the dataset, a higher proportion of matching admission records is expected.

Reason for Discharge

Table 6.3a and 6.3b and Figure 39 present reason for discharge and length of stay by type of service. Two measures of length of stay (median and average) are included. Of the Year 2001 discharges, 39 percent completed treatment and 11 percent transferred to another treatment program. One in four (24 percent) left against professional advice, while the treatment of an additional 19 percent was terminated by the facility.

The treatment completion rate was 50 percent or more among admissions to short-term and hospital residential/rehabilitation treatment (63 percent and 53 percent, respectively), and to detoxification (50 percent). Completion rates were lower in longer-term and less structured settings. For intensive outpatient treatment, the completion rate was 35 percent. For outpatient treatment, it was 34 percent, and for long-term residential/rehabilitation treatment, it was 29 percent.

The completion rate was lowest among discharges from methadone treatment (14 percent). Of those who were discharged from methadone treatment, 66 percent either left against professional advice or had their treatment terminated by the facility.

Admissions to hospital residential/rehabilitation facilities were the most likely to have been transferred to further substance abuse treatment (22 percent). In each of the other service types, 8 to 13 percent were transferred to further treatment.

Figure 39
Reason for discharge by type of service: TEDS 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Treatment Completion

Admissions for various primary substances were likely to be admitted to different types of service [Table 3.4 ]. Discharges reflected this variation, and there were different treatment completion rates for each of the service types.

Tables 6.4-6.9 present, for each type of service, the reason for discharge and length of stay by primary substance of abuse at admission.

Tables 6.10a and 6.10b present reason for discharge and length of stay by type of service for discharges from methadone treatment.

Figure 40. Among alcohol discharges, 44 percent were from outpatient treatment and 25 percent were from detoxification.

Almost half of opiate discharges (41 percent) were from detoxification. Twenty-nine percent were from methadone treatment and 14 percent were from outpatient treatment.

Among cocaine discharges, more than one-third (37 percent) were from outpatient treatment, 23 percent were from detoxification, and 16 percent were from intensive outpatient treatment.

Among marijuana discharges, 60 percent were from outpatient treatment and 20 percent were from intensive outpatient.

Among stimulant discharges, 37 percent were from outpatient, 17 percent were from intensive outpatient treatment, and almost 15 percent each were from detoxification, short-term, and long-term residential/rehabilitation treatment.

Figure 40
Type of service by primary substance: TEDS Discharges 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 41. For primary alcohol discharges, treatment completion rates ranged from 36 percent, for long-term residential treatment, to 70 percent for short-term residential treatment, averaging 48 percent. Completion rates for the most common types of services were 43 percent for outpatient and 53 percent for detoxification.

Figure 41
Primary alcohol discharges by type of service, and treatment completion
within service type: TEDS 2001
Percent distribution

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 42. For opiate discharges, treatment completion rates ranged from 13 percent for methadone to 54 percent for short-term residential treatment, averaging 30 percent. The completion rate for the most common type of service, detoxification, was 46 percent.

Figure 42
Primary opiate discharges by type of service, and treatment completion
within service type: TEDS 2001
Percent distribution

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 43. Treatment completion rates for cocaine discharges ranged from 19 percent for outpatient treatment (the most common type of service) to 57 percent for short-term residential treatment, averaging 31 percent. Completion rates for other common types of services were 21 percent for intensive outpatient and 52 percent for detoxification.

Figure 43
Primary cocaine discharges by type of service, and treatment completion
within service type: TEDS 2001
Percent distribution

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 44. Treatment completion rates for marijuana discharges ranged from 27 percent for long-term residential treatment to 60 percent for short-term residential treatment, averaging 34 percent. The completion rate for the most common types of services were 30 percent for outpatient and 33 percent for intensive outpatient treatment.

Figure 44
Primary marijuana discharges by type of service, and treatment completion
within service type: TEDS 2001
Percent distribution

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 45. For stimulant discharges, treatment completion rates ranged from 24 percent for long-term residential treatment to 54 percent for short-term residential treatment, averaging 34 percent. The completion rate for the most common type of service, outpatient, was 25 percent.

Figure 45
Primary stimulant discharges by type of service, and treatment completion
within service type: TEDS 2001
Percent distribution

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Length of Stay

Table 6.3b-6.10b. Both the average and median lengths of stay were calculated. Most persons remained in treatment for a relatively short period of time, as represented by the median. However, some were reported as remaining in treatment for extended periods, and thus the average length of stay is generally longer than the median.

Figures 46-51 present the median and average lengths of stay for persons completing treatment in different types of service and for different primary substances. The median length of stay for persons completing treatment ranged from 5 days for detoxification to 92 days for outpatient treatment. The average length of stay was longer, ranging from 11 days for those completing detoxification to 122 days for those completing outpatient treatment. Within the different service types, however, there was little variation in median length of stay by primary substance.

Figure 46
Outpatient treatment
Length of stay among treatment completers by primary substance at admission:
TEDS 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 47
Intensive outpatient treatment
Length of stay among treatment completers by primary substance at admission:
TEDS 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 48
Short-term residential/rehabilitation treatment
Length of stay among treatment completers by primary substance at admission:
TEDS 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 49
Long-term residential/rehabilitation treatment
Length of stay among treatment completers by primary substance at admission:
TEDS 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 50
Hospital residential/rehabilitation treatment
Length of stay among treatment completers by primary substance at admission:
TEDS 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.

 

Figure 51
Detoxification
Length of stay among treatment completers by primary substance at admission:
TEDS 2001

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 5.31.03.