Abstract: Drug and alcohol problems are a major factor in presentation to hospital and contribute to longer stays and repeat admissions. Consultation Liaison (CL) services are an intervention in hospital settings designed to provide direct access to specialist services for support, treatment advice and assistance with the management of a given condition. Drug and alcohol (D&A) CL services aim to improve identification and treatment of patients with D&A morbidity. The aim of this study was to evaluate the costs and consequences of D&A CL services in New South Wales hospitals. The study was undertaken by the National Centre for Drug and Alcohol Research and the Centre for Health Economics Research and Evaluations, and involved a snapshot of prevalence of drug and alcohol problems in patients presenting to NSW hospitals, combined with a follow-up to evaluate the impact of CL services on patient utilisation of services and outcomes.
Patients were surveyed at eight hospitals and problematic D&A use was identified using the Alcohol, Smoking and Substance Involvement Screening Test. For consenting participants, medical record data was obtained from 18 months pre- to 12 months post-survey. Interrupted time series analyses were used to compare utilisation and costs for patients with and without D&A problems and changes over time between those who received D&A CL and similar patients.
Approximately 35% of patients surveyed had D&A problems (excluding tobacco) with 7% requiring intensive treatment. Only 24% of patients requiring intensive treatment were treated by D&A CL. Those treated had relative improvements over time in length-of-stay, emergency admission performance, presentation and admission rates, and increased uptake of selected pharmaceuticals. The estimated net benefit of D&A CL services was at least $100,000 savings per hospital per year. This research demonstrates that expansion of D&A CL services to address current unmet need has the potential to provide significant savings for hospitals.
Professor Rosalie Viney, Centre for Health Economics Research and Evaluation, UTS
Ms Kerryn Butler, National Drug and Alchohol Research Centre, UNSW
Dr Rebecca Reeve, Centre for Social Impact, University of NSW
Associate Professor Adrian Dunlop, NSW Health
Date: Wednesday, 6 May 2015
Time: 12:00pm – 1:30 pm (No food/drink is allowed in the classroom)
Venue: UTS Business School
Dr Chau Chak Wing Building (Building 8)
Level 4, Room 002
14-28 Ultimo Road, Ultimo
RSVP to firstname.lastname@example.org by Tuesday, 5 May (limited space)