ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Addictive Disorders
This article is part of the Research TopicEmerging Treatment Approaches for Substance Use DisordersView all 9 articles
Rates and Factors for 30-Day Readmission in Patients with Substance Use Disorders During the COVID-19 Pandemic
Provisionally accepted
- The Pennsylvania State University (PSU), University Park, United States
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Abstract Background: Substance use disorders (SUD) are associated with frequent hospitalizations, premature discharge, and high rates of early readmission. The COVID-19 pandemic further disrupted addiction care continuity, heightening vulnerability among hospitalized patients. Identifying inpatient factors linked to reduced 30-day readmission may guide strategies to improve post-discharge outcomes for this population. Methods: We conducted a retrospective cohort study of adults with SUD admitted to Penn State Health Hershey Medical Center between January 1 and December 30, 2021, who received addiction medicine consultations. Demographic, social, and clinical characteristics were extracted from electronic health records. Logistic regression was used to assess associations between addiction interventions, including educational counseling, pharmacotherapy initiation, and other referrals, and 30-day all-cause readmission, adjusting for age, sex, marital status, insurance, and comorbidities. Results: Among 561 patients (mean age, 42 years; 62% men), 139 (25%) were readmitted within 30 days. Depression or anxiety was present in 44% of patients, and 42% reported polysubstance use. Single marital status and the presence of one or more comorbidities were independently associated with higher odds of readmission (adjusted odds ratio [aOR], 2.82; 95% CI, 1.45– 5.52; P = .002, and aOR, 2.41; 95% CI, 1.06–5.45; P = .035, respectively). Compared with those who declined assistance, patients who received educational counseling had significantly lower odds of readmission (aOR, 0.53; 95% CI, 0.31–0.90; P = .02), and those initiated on addiction-related medications showed a nonsignificant trend toward reduced risk (aOR, 0.62; 95% CI, 0.32–1.21; P = .16). In contrast, patients who experienced a self-directed discharge had more than threefold higher odds of readmission (aOR, 3.02; 95% CI, 1.36–6.73; P = .007). Conclusion: In this cohort of hospitalized patients with substance use disorders, inpatient addiction interventions were associated with significantly lower 30-day readmission rates. Educational counseling and pharmacotherapy initiation reduced readmission risk, whereas a self-directed discharge was linked to markedly higher odds of readmission. These findings support the integration of structured addiction consultation services to improve post-discharge outcomes and reduce preventable hospital utilization.
Keywords: substance use disorder, Addiction medicine, Hospital readmission, Pharmacotherapy, inpatient consultation, Health Services Research
Received: 26 Jun 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 Ssentongo, MD, PhD, Nunez, Disinger and Bhavna. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Paddy Ssentongo, MD, PhD, pssentongo@pennstatehealth.psu.edu
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