Chapter 2

Discharge Data Description and Data Overview for All Types of Service: 2006

Data Definitions
Data Overview
Reason for Discharge by Type of Service
Median LOS by Type of Service and Reason for Discharge
Characteristics at Admission
Treatment Completion or Transfer to Further Treatment

Chapter 2 describes the discharge data and provides an overview of the 1,502,285 linked admission/discharge records for discharges in 2006 in 42 reporting States [Table 2.1a]. States are asked to submit a record for each initial admission to a treatment service and a record for each transfer from one service to another, and a discharge record corresponding to each admission or transfer. The linked pairs of admission/transfer and discharge records enable analyses of treatment completion and length of stay (LOS) in treatment in specific service types. The data presented here do not represent complete treatment episodes; a single episode may involve stays in more than one service type.

Data Definitions

Type of Service

Data are presented for each of eight different types of service (listed below). The first six service types exclude records where medication-assisted (i.e., with methadone or buprenorphine) opioid therapy or detoxification was planned as part of treatment; the other two service types include only medication-assisted opioid therapy or detoxification records:

Medication-assisted opioid therapy discharges from short- and long-term residential treatment and hospital residential treatment represented 3 percent of all records. They are excluded from the chapters that detail the eight specific service types listed above.

Reason for Discharge

The reasons for discharge from substance abuse treatment tabulated in this report include:

Because both treatment completion and transfer to further treatment represent positive conclusions to a treatment episode or component of a treatment episode, their rates are combined in some of the analyses.

Length of Stay (LOS) in Treatment

The length of stay (LOS) in days was calculated for each record by subtracting the date of admission from the date of last contact. Records where the date of admission and the date of last contact were the same (LOS = 0 days) were excluded from the analysis. For all outpatient service types, one day was added so that both the day of admission and the day of last contact were counted as days on which services were delivered. For hospital and residential service types, this was not done. The measure of LOS used in this report is the median—the number of days at which half of all discharges had taken place.

Data Overview

Tables 2.1a and 2.1b. A total of 1,689,794 records for discharges in 2006 were submitted by 42 States. This report excluded records where the length of stay (LOS) was 0 days (n = 120,383; 7 percent) and records where the reason for discharge was unknown or missing (n = 28,407; 2 percent), leaving 1,541,004 eligible discharge records. Ninety-seven percent of the eligible discharge records (n = 1,502,285) could be linked to a TEDS admission or transfer record from 2000 through 2006. (Most of the 2006 discharge records linked to an admission or transfer record from 2006 or 2005; only a small proportion linked to records from 2004 or earlier.)

Type of Service

Tables 2.2a and 2.2b present type of service at discharge by State for discharges in 2006. There was considerable State-to-State variability in the combination of service types available and in the proportions discharged from each of these service types.

Figure 2.1. Overall, 41 percent of discharges were from outpatient treatment, 23 percent were from detoxification, 11 percent were from intensive outpatient treatment, 10 percent were from short-term residential treatment, 8 percent were from long-term residential treatment, 5 percent were from medication-assisted opioid therapy or detoxification, and less than 1 percent were from hospital residential treatment.1

Figure 2.1
Type of service at discharge: TEDS 2006

Pie chart comparing Type of service at discharge in TEDS 2006

Reason for Discharge

Tables 2.3a and 2.3b present reason for discharge by State.

Figure 2.2. Of the 1,502,285 discharges in 2006:

Reason for Discharge by Type of Service

Table 2.4 and Figure 2.3 present reason for discharge by type of service. The treatment completion rate was greater than 50 percent among discharges from hospital residential treatment (70 percent), detoxification (67 percent), and short-term residential treatment (59 percent). Completion rates were lower in longer-term and/or less structured settings: 44 percent for long-term residential treatment, 40 percent for outpatient treatment, and 39 percent for intensive outpatient treatment.

Figure 2.2
Reason for discharge: TEDS 2006

Pie chart comparing Reason for discharge in TEDS 2006

Completion rates were also relatively low for medication-assisted opioid detoxification (33 percent) and for outpatient medication-assisted opioid therapy (12 percent).

Transfer to further substance abuse treatment was most common among discharges from medication-assisted opioid detoxification (22 percent), followed by outpatient medication-assisted opioid therapy (18 percent) and intensive outpatient treatment and hospital residential treatment (17 percent each). Treatment dropouts were most common among outpatient medication-assisted opioid therapy and medication-assisted opioid detoxification discharges, at 41 percent each.

Median LOS by Type of Service and Reason for Discharge

Linkage of discharge records from 2006 to admission records from 2000 to 2006 means that the maximum length of stay (LOS) in treatment included in this report is 7 years. However, medication-assisted opioid therapy can have a much longer duration. Indeed, some admissions may receive this form of treatment for an indefinite period. Because this report includes data only on discharges, it will underestimate LOS in treatment for those receiving medication-assisted opioid therapy. Similarly, the number and proportion of treatment completers will reflect only those who have been discharged because treatment is complete and not those who successfully remain in long-term medication-assisted opioid therapy. In addition, the characteristics at admission of those admitted to and discharged from medication-assisted opioid therapy within 7 years may differ from those of admissions who remain in medication-assisted opioid therapy for longer than 7 years.

Figure 2.3
Reason for discharge, by type of service: TEDS 2006

Bar chart comparing Reason for discharge, by type of service: TEDS 2006

Table 2.4 and Figure 2.4. The median LOS was longest for discharges from outpatient medication-assisted opioid therapy (156 days), followed by outpatient treatment (87 days), long-term residential treatment (58 days), and intensive outpatient treatment (50 days). The median LOS for all discharges from short-term residential treatment was 22 days; from hospital residential treatment, 17 days; from medication-assisted opioid detoxification, 14 days; and from detoxification, 4 days.

In all service types except medication-assisted opioid detoxification, the median LOS was longer for discharges who completed treatment than for those who transferred to further treatment or who did not complete treatment. Among discharges completing treatment, the median LOS was longest for discharges from outpatient medication-assisted opioid therapy (183 days), followed by outpatient treatment (121 days), long-term residential treatment (90 days), and intensive outpatient treatment (64 days). The median LOS for treatment completers in short-term residential treatment was 27 days; for hospital residential treatment, 20 days; for medication-assisted opioid detoxification, 10 days; and for detoxification, 4 days.

Figure 2.4
Median length of stay, by reason for discharge and type of service: TEDS 2006

Bar chart comparing Median length of stay, by reason for discharge and type of service in TEDS 2006

Characteristics at Admission

Tables 2.5 and 2.6 summarize the number and percent distributions of selected characteristics at admission for all discharges and for discharges by service type. Summary findings for all discharges combined at the time of admission include:

Characteristics at Admission by Type of Service

Table 2.6. Although the characteristics at admission of discharges varied by service type, some general observations can be made.

Treatment Completion or Transfer to Further Treatment

Table 2.7 presents the percent of discharges either completing treatment or transferring to further treatment by selected characteristics at admission, for all discharges and by service type. For all service types combined, the combined treatment completion/transfer rate was 60 percent. There was more variation in completion/transfer rates by service type than by characteristic at admission. Treatment/completion rates ranged from 30 percent among discharges from outpatient medication-assisted opioid therapy to 87 percent among discharges from hospital residential treatment, while the largest variation by characteristic at admission was for primary substance, ranging from 53 percent for marijuana to 69 percent for alcohol).

For all discharges combined, however, some general observations can be made. Treatment completion/transfer rates for all discharges combined were somewhat higher for males and for non-Hispanic Whites, and increased with both age and education. The rate was higher for discharges whose primary substance was alcohol, and for those who were employed.


1Percentages do not sum to 100 percent because of rounding.

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