Chapter 2

Discharge Data Description and Data Overview for All Types of Service: 2007

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 linked admission/discharge records for discharges in 2007. 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:


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

Medication-assisted opioid therapy discharges from short- and long-term residential treatment and hospital residential treatment represented less than 1 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. 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 and records where the date of admission and the date of last contact were the same (LOS = 0 days) were excluded from the analysis. 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

A total of 1,740,879 records for discharges in 2007 were submitted by 46 States. This report excluded records where the length of stay (LOS) was 0 days (n = 63,290; 4 percent) and records where the reason for discharge was unknown or missing (n = 48,226; 3 percent), yielding 1,669,873 eligible discharge records.

Table 2.1a-b. Of the 1,669,873 eligible discharge records, 98 percent (n = 1,629,363) could be linked to a TEDS admission or transfer record from 2000 through 2007. Most of the 2007 discharge records linked to an admission or transfer record from 2007 or 2006; only a small proportion linked to records from 2005 or earlier.

Type of Service

Table 2.2a-b and Figure 2.1 . These tables present type of service at discharge by State for discharges in 2007. 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 illustrates that, of the discharges in 2007, 45 percent were from outpatient treatment, 20 percent were from detoxification, 11 percent were from intensive outpatient treatment, 11 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.

Figure 2.1
Type of service at discharge: TEDS 2007

Pie chart comparing Type of Service at Discharge in TEDS 2007

Reason for Discharge

Table 2.3a-b and Figure 2.2. These tables present reason for discharge by State. Figure 2.2 illustrates that, of the discharges in 2007:

Figure 2.2
Reason for discharge: TEDS 2007

Pie chart comparing Reason for discharge in TEDS 2007

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 highest among discharges from detoxification (66 percent), and short-term residential treatment (57 percent), and hospital residential treatment (50 percent). Completion rates were lower in longer-term and/or less structured settings: 46 percent for long-term residential treatment, 38 percent for outpatient treatment, and 34 percent for intensive outpatient treatment. Completion rates were lowest for medication-assisted opioid detoxification (30 percent) and for outpatient medication-assisted opioid therapy (12 percent).

Transfer to further substance abuse treatment was most common among discharges from hospital residential treatment (28 percent), intensive outpatient treatment (22 percent), medication-assisted opioid detoxification (21 percent), and outpatient medication-assisted opioid therapy (19 percent).

Treatment dropout was highest among discharges from outpatient medication-assisted opioid therapy (46 percent) and medication-assisted opioid detoxification (42 percent).

Figure 2.3
Reason for discharge, by type of service: TEDS 2007

Stacked bar chart comparing Reason for discharge, by type of service in TEDS 2007

Median LOS by Type of Service and Reason for Discharge

Linkage of discharge records from 2007 to admission records from 2000 to 2007 means that the maximum length of stay (LOS) in treatment included in this report is 8 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 8 years may differ from those of admissions who remain in medication-assisted opioid therapy for longer than 8 years.

Table 2.4. The median LOS was longest for discharges from outpatient medication-assisted opioid therapy (155 days), followed by outpatient treatment (77 days), long-term residential treatment (58 days), and intensive outpatient treatment (51 days). The median LOS for all discharges from short-term residential treatment was 24 days; from medication-assisted opioid detoxification, 17 days; from hospital residential treatment, 8 days; and from detoxification, 4 days.

Figure 2.4 In all service types the median LOS for discharges who completed treatment was longer than or equal to 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 (184 days), followed by outpatient treatment (118 days), long-term residential treatment (89 days), and intensive outpatient treatment (72 days). The median LOS for treatment completers in short-term residential treatment was 27 days; for medication-assisted opioid detoxification, 21 days; for hospital residential treatment, 18 days; and for detoxification, 4 days.

Figure 2.4
Median length of stay, by reason for discharge
and type of service: TEDS 2007

Bar chart comparing Median length of stay, by reason for discharge
and type of service in TEDS 2007

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.

Completion/transfer rates were generally similar within admission characteristics, but varied widely by service type. Treatment completion/transfer rates ranged from 32 percent among discharges from outpatient medication-assisted opioid therapy to 78 percent among discharges from detoxification, while the largest variation by admission characteristic was for primary substance, ranging from 53 percent for marijuana to 67 percent for alcohol).

For all discharges combined, however, some general observations can be made. The treatment completion/transfer rate for all discharges combined:

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