Chapter 7
Hospital Residential Treatment Discharges: 2004

Chapter 7 presents data on the reasons for discharge and length of stay (LOS) in treatment for the 8,080 linked admission/discharge records of clients discharged from hospital residential treatment in 2004 in 14 States [Table 7.1].

Table 7.1 and Figure 7.1 present the distribution of reasons for discharge for discharges from hospital residential treatment. Overall, 5,597 (69 percent) of hospital residential discharges completed treatment, 1,200 (15 percent) were transferred to further treatment, 884 (11 percent) dropped out of treatment, 214 (3 percent) had treatment terminated by the facility, and 185 (2 percent) failed to complete treatment for other reasons. Table 7.1 also presents reason for discharge by State.

Figure 7.1
Reason for discharge from hospital residential treatment: TEDS 2004

Pie chart comparing Reason for discharge from hospital residential treatment in TEDS 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Figure 7.2, Table 2.5, and Appendix Table C.6. The median LOS for hospital residential treatment was 11 days. The average (mean) LOS was longer, 29 days (standard deviation, 95). The average LOS was longer than the median LOS for most reasons for discharge for most client characteristics.

Figure 7.2
Median and average lengths of stay in hospital residential treatment, by reason for discharge: TEDS 2004

Bar chart comparing Median and average lengths of stay in hospital residential treatment, by reason for discharge in TEDS 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Hospital residential clients who completed treatment remained in treatment longer than clients who did not complete treatment. Among treatment completers, median LOS was 14 days, and among clients transferred to further treatment, it was 9 days. Among clients who dropped out of treatment, the median LOS was 7 days; among those whose treatment was terminated by the facility, it was 12 days; and among those who failed to complete treatment for other reasons, the median LOS was 13 days.

In comparison with all discharges combined, clients discharged from hospital residential treatment were more likely:

Clients discharged from hospital residential treatment were less likely than all discharges combined:

Demographics

Tables 7.2-7.4 and Figures 7.3-7.5. Sixty-four percent of clients discharged from hospital residential treatment were male. The peak age group at admission was 40 to 49 years (27 percent of all hospital residential treatment discharges), followed by 30 to 39 years (25 percent). Twenty percent were ages 20 to 29, and 13 percent each were ages 15 to 19 and age 50 and older. A small proportion (1 percent) were younger than age 15.* Most clients discharged from hospital residential treatment were non-Hispanic White (76 percent), while 13 percent were non-Hispanic Black, 6 percent were of Hispanic origin, and 5 percent were of other racial/ethnic groups.

Table 7.2 and Figure 7.3. Males and females were about equally likely to complete hospital residential treatment or to be transferred to further treatment (85 percent and 83 percent, respectively). Males had a longer median LOS among hospital residential treatment completers (15 days) than did females (13 days).


* Percentages do not sum to 100 percent because of rounding.
Figure 7.3
Hospital residential treatment completion or transfer to further treatment, by gender: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by gender in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Table 7.3 and Figure 7.4. Clients in the older and younger age groups were more likely either to complete outpatient treatment or to be transferred to further treatment than clients in the middle age groups. The combined rate was 88 percent among clients who were younger than age 15. It fell to 80 percent among those who were ages 20 to 29, then increased with age to 89 percent among those who were age 50 and older.

The median LOS for hospital residential treatment completers was longer among the middle age groups. The median LOS was 5 days among clients who were younger than age 15 years of age. It rose to 19 days among those who were ages 20 to 29, then fell to 12 days among those who were age 50 and older.

Figure 7.4
Hospital residential treatment completion or transfer to further treatment, by age at admission: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by age at admission in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Table 7.4 and Figure 7.5. Non-Hispanic Whites and discharges of Hispanic origin were more likely either to complete hospital residential treatment or to be transferred to further treatment (85 percent and 83 percent, respectively) than were non-Hispanic Blacks (77 percent).

The median LOS among hospital residential treatment completers was longest (18 days) among non-Hispanic Blacks, 16 days among discharges of Hispanic origin, and shortest (14 days) among non-Hispanic Whites.

Figure 7.5
Hospital residential treatment completion or transfer to further treatment, by race/ethnicity: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by race/ethnicity in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Primary Substance

Table 7.5 and Figure 7.6. Forty-six percent of clients discharged from hospital residential treatment reported alcohol as their primary substance of abuse at admission. Opiates were reported by 15 percent, marijuana by 12 percent, cocaine by 11 percent, stimulants by 10 percent, and other substances by 6 percent.

Clients who reported alcohol as their primary substance had the highest combined rate of hospital residential treatment completion or transfer to further treatment (88 percent). The combined rate was lowest for clients who reported cocaine (79 percent).

Clients who reported cocaine as their primary substance had the longest median LOS for the major substances of abuse (alcohol, opiates, marijuana, cocaine, and stimulants) among hospital residential treatment completers (21 days), and clients who reported marijuana had the shortest (6 days).

Figure 7.6
Hospital residential treatment completion or transfer to further treatment, by primary substance: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by primary substance in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Frequency of Use

Table 7.6 and Figure 7.7. Sixty percent of hospital residential treatment discharges reported daily use of their primary substance in the month before entering treatment, while 9 percent reported no use in that period.

The combined rate of hospital residential treatment completion or transfer to further treatment displayed no consistent pattern with frequency of use and was between 77 percent and 85 percent.

Clients with less frequent substance use before treatment entry who completed hospital residential treatment had a longer median LOS than did clients with more frequent substance use. The median LOS was longest (16 days) among those who reported no primary substance use in the month before treatment entry. It fell to 10 days among those who reported daily use.

Figure 7.7
Hospital residential treatment completion or transfer to further treatment, by frequency of substance use in the past month: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by frequency of substance use in the past month in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Age at First Use

Table 7.7 and Figure 7.8. More than two-thirds (69 percent) of hospital residential treatment discharges first used their primary substance by age 18. The peak age at first use was 15 to 16 years (23 percent of hospital residential treatment discharges). Thirteen percent did not begin use until they were over age 25.

Clients who were younger when they began their substance use were generally more likely either to complete hospital residential treatment or to be transferred to further treatment than were clients whose use began later. The combined rate was 87 percent among those whose substance use began at ages 13 to 14, and fell to 79 percent among those whose use began when they were over age 25.

The median LOS for hospital residential treatment completers showed no consistent pattern with age at first use of the primary substance and was between 12 days and 20 days.

Figure 7.8
Hospital residential treatment completion or transfer to further treatment, by age at first use: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by age at first use in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Prior Treatment

Table 7.8 and Figure 7.9. Almost one-third (31 percent) of hospital residential treatment discharges had never been in treatment before, while 10 percent had been in treatment five or more times previously.

Clients with no prior treatment episodes had the highest combined rate of hospital residential treatment completion or transfer to further treatment (87 percent), and those who had been in treatment five or more times before had the lowest (79 percent). Combined rates between these extremes showed no consistent pattern with the number of prior treatment episodes and were between 82 percent and 86 percent.

The median LOS among hospital residential treatment completers displayed no consistent pattern with the number of prior treatment episodes and was between 10 days and 14 days.

Figure 7.9
Hospital residential treatment completion or transfer to further treatment, by number of prior treatment episodes: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by number of prior treatment episodes in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Treatment Referral Source

Table 7.9 and Figure 7.10. More than half (52 percent) of clients discharged from hospital residential treatment were self- or individual referrals to treatment, and 13 percent were referred to treatment through the criminal justice system. Health care providers made up 14 percent, substance abuse treatment providers 12 percent, community referrals 8 percent, employers 1 percent, and schools less than 1 percent.*

The combined rates of hospital residential treatment completion or transfer to further treatment were below the hospital residential treatment average of 84 percent for those referred to treatment through health care providers (80 percent) and community sources (79 percent).

The median LOS among hospital residential treatment completers was 11 days for self- or individual referrals. The median LOS was 19 days among those referred to treatment through the criminal justice system and by community sources, and longest (20 days) among those referred by a health care provider or employer. The median LOS for hospital residential treatment completers referred by other sources was between 6 days and 8 days.


* Percentages do not sum to 100 percent because of rounding.
Figure 7.10
Hospital residential treatment completion or transfer to further treatment, by treatment referral source: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by treatment referral source in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Employment Status

Table 7.10 and Figure 7.11. Forty percent of clients age 16 and older discharged from hospital residential treatment were unemployed. Thirty-five percent were not in the labor force, and 26 percent were employed either full time or part time.*

Clients who were employed were more likely either to complete hospital residential treatment or to be transferred to further treatment than were clients who were unemployed or not in the labor force. The combined rate was highest among those employed full time (88 percent). The combined rate was 85 percent among those employed part time, but also among those who were unemployed. The combined rate fell to 80 percent among those who were not in the labor force.

The median LOS among hospital residential treatment completers displayed no consistent pattern with employment status and was between 10 days and 21 days.


* Percentages do not sum to 100 percent because of rounding.
Figure 7.11
Hospital residential treatment completion or transfer to further treatment, by employment status: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by employment status in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

Education

Table 7.11 and Figure 7.12. Forty-four percent of clients age 18 and older discharged from hospital residential treatment had 12 years of education or a GED. Thirty-one percent had more than 12 years of education, 21 percent had 9 to 11 years of education, and 3 percent had 8 years of education or less.*

Clients with more education were more likely either to complete hospital residential treatment or to be transferred to further treatment than clients with less education. The combined rate was highest among those with more than 12 years of education (86 percent). It fell to 77 percent among clients with 8 years of education or less.

The median LOS among clients completing hospital residential treatment displayed no consistent pattern with years of education and was between 18 days and 20 days.


* Percentages do not sum to 100 percent because of rounding.
Figure 7.12
Hospital residential treatment completion or transfer to further treatment, by years of education: TEDS 2004

Stacked bar chart comparing hospital residential treatment completion or transfer to further treatment, by years of education in TEDS 2004

Figure legend

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.2006.

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