In a hospital, consultation/liaison services are specialty services provided bedside directly to the patient.
In a hospital, consultation/liaison services are specialty services provided bedside directly to the patient.
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Addiction consultation/liaison (CL) services are interventions that are provided for individuals admitted to a hospital for another health condition. For example, the addiction CL service may be called to meet with an individual hospitalized for liver dysfunction if he/she has a suspected drinking problem.
To help shed light on this issue, Reeve and colleagues conducted this naturalistic study of addiction consultation/liaison (CL) services on future health care utilization and cost-benefit for individuals with suspected alcohol or other drug problems to help shed light on this issue.
The study was conducted at eight hospitals in New South Wales, Australia for 1615 patients, all of whom were 17 years or older (41 years old, on average) and could provide consent to participate. Of these, 1101 gave permission for study authors to obtain follow-up health care data to analyze benefits of addiction consultation/liaison (CL) services. Patient data were obtained across a 2.5-year period: 1.5 years before they were assessed in the hospital, and 1 year after they were assessed.
The analyses focused on the change in trends from the time before the hospital admission to the time after the hospital admission. This “interrupted time-series” study design is a common method for trying to determine whether a naturalistic intervention not implemented or controlled by the research team was likely responsible for any observed changes in the patient after receiving the intervention – addiction consultation/liaison (CL) in this case.
Based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) a substance use problem screening instrument created by the World Health Organization, given while they were in the hospital, authors created four groups of patients:
Specific attention was paid to the comparison between groups 3 and 4 in this study because those at high risk for having an alcohol and other drug problem have the greatest potential to benefit from a bedside intervention intended to facilitate engagement in specialty addiction treatment.
Controlling for a host of demographic factors, and the hospital to which the individual was admitted, for those who screened positive for high risk of having an alcohol or other drug problem requiring intensive treatment, receiving consultation/liaison (CL) was related to greater likelihood that the patient later would be admitted to the hospital within common hospital benchmarks of 4 hours and 8 hours after a decision was made to admit the patient – these benchmarks are measures of hospital efficiency and safety.
However, there is no discernible impact of consultation/liaison (CL) on subsequent medical service utilization. While those who received CL services may spend fewer hours in the emergency room and an overall decrease in overall hospital admissions, these differences were not statistically significant (i.e., were not large enough to be considered statistically reliable).
For each patient receiving consultation/liaison (CL) for the first time in a given year, the hospital saves an average of $203 dollars per year. For the hospitals examined in this study, based on the number of patients receiving CL, this results in savings of more than $100,000 Australian dollars ($73,000 U.S. dollars) even after accounting for the cost of implementing the CL service.
This study is important as an initial step in determining the benefits of providing addiction consultation/liaison (CL) services in a medical hospital.
One seemingly logical next step is to test a semi-structured addiction consultation/liaison (CL) intervention in a randomized controlled trial against, for example, usual medical care.
Reeve, R., Arora, S., Butler, K., Viney, R., Burns, L., Goodall, S., & van Gool, K. (2016). Evaluating the impact of hospital based drug and alcohol consultation liaison services. Journal of Substance Abuse Treatment.
l
Addiction consultation/liaison (CL) services are interventions that are provided for individuals admitted to a hospital for another health condition. For example, the addiction CL service may be called to meet with an individual hospitalized for liver dysfunction if he/she has a suspected drinking problem.
To help shed light on this issue, Reeve and colleagues conducted this naturalistic study of addiction consultation/liaison (CL) services on future health care utilization and cost-benefit for individuals with suspected alcohol or other drug problems to help shed light on this issue.
The study was conducted at eight hospitals in New South Wales, Australia for 1615 patients, all of whom were 17 years or older (41 years old, on average) and could provide consent to participate. Of these, 1101 gave permission for study authors to obtain follow-up health care data to analyze benefits of addiction consultation/liaison (CL) services. Patient data were obtained across a 2.5-year period: 1.5 years before they were assessed in the hospital, and 1 year after they were assessed.
The analyses focused on the change in trends from the time before the hospital admission to the time after the hospital admission. This “interrupted time-series” study design is a common method for trying to determine whether a naturalistic intervention not implemented or controlled by the research team was likely responsible for any observed changes in the patient after receiving the intervention – addiction consultation/liaison (CL) in this case.
Based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) a substance use problem screening instrument created by the World Health Organization, given while they were in the hospital, authors created four groups of patients:
Specific attention was paid to the comparison between groups 3 and 4 in this study because those at high risk for having an alcohol and other drug problem have the greatest potential to benefit from a bedside intervention intended to facilitate engagement in specialty addiction treatment.
Controlling for a host of demographic factors, and the hospital to which the individual was admitted, for those who screened positive for high risk of having an alcohol or other drug problem requiring intensive treatment, receiving consultation/liaison (CL) was related to greater likelihood that the patient later would be admitted to the hospital within common hospital benchmarks of 4 hours and 8 hours after a decision was made to admit the patient – these benchmarks are measures of hospital efficiency and safety.
However, there is no discernible impact of consultation/liaison (CL) on subsequent medical service utilization. While those who received CL services may spend fewer hours in the emergency room and an overall decrease in overall hospital admissions, these differences were not statistically significant (i.e., were not large enough to be considered statistically reliable).
For each patient receiving consultation/liaison (CL) for the first time in a given year, the hospital saves an average of $203 dollars per year. For the hospitals examined in this study, based on the number of patients receiving CL, this results in savings of more than $100,000 Australian dollars ($73,000 U.S. dollars) even after accounting for the cost of implementing the CL service.
This study is important as an initial step in determining the benefits of providing addiction consultation/liaison (CL) services in a medical hospital.
One seemingly logical next step is to test a semi-structured addiction consultation/liaison (CL) intervention in a randomized controlled trial against, for example, usual medical care.
Reeve, R., Arora, S., Butler, K., Viney, R., Burns, L., Goodall, S., & van Gool, K. (2016). Evaluating the impact of hospital based drug and alcohol consultation liaison services. Journal of Substance Abuse Treatment.
l
Addiction consultation/liaison (CL) services are interventions that are provided for individuals admitted to a hospital for another health condition. For example, the addiction CL service may be called to meet with an individual hospitalized for liver dysfunction if he/she has a suspected drinking problem.
To help shed light on this issue, Reeve and colleagues conducted this naturalistic study of addiction consultation/liaison (CL) services on future health care utilization and cost-benefit for individuals with suspected alcohol or other drug problems to help shed light on this issue.
The study was conducted at eight hospitals in New South Wales, Australia for 1615 patients, all of whom were 17 years or older (41 years old, on average) and could provide consent to participate. Of these, 1101 gave permission for study authors to obtain follow-up health care data to analyze benefits of addiction consultation/liaison (CL) services. Patient data were obtained across a 2.5-year period: 1.5 years before they were assessed in the hospital, and 1 year after they were assessed.
The analyses focused on the change in trends from the time before the hospital admission to the time after the hospital admission. This “interrupted time-series” study design is a common method for trying to determine whether a naturalistic intervention not implemented or controlled by the research team was likely responsible for any observed changes in the patient after receiving the intervention – addiction consultation/liaison (CL) in this case.
Based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) a substance use problem screening instrument created by the World Health Organization, given while they were in the hospital, authors created four groups of patients:
Specific attention was paid to the comparison between groups 3 and 4 in this study because those at high risk for having an alcohol and other drug problem have the greatest potential to benefit from a bedside intervention intended to facilitate engagement in specialty addiction treatment.
Controlling for a host of demographic factors, and the hospital to which the individual was admitted, for those who screened positive for high risk of having an alcohol or other drug problem requiring intensive treatment, receiving consultation/liaison (CL) was related to greater likelihood that the patient later would be admitted to the hospital within common hospital benchmarks of 4 hours and 8 hours after a decision was made to admit the patient – these benchmarks are measures of hospital efficiency and safety.
However, there is no discernible impact of consultation/liaison (CL) on subsequent medical service utilization. While those who received CL services may spend fewer hours in the emergency room and an overall decrease in overall hospital admissions, these differences were not statistically significant (i.e., were not large enough to be considered statistically reliable).
For each patient receiving consultation/liaison (CL) for the first time in a given year, the hospital saves an average of $203 dollars per year. For the hospitals examined in this study, based on the number of patients receiving CL, this results in savings of more than $100,000 Australian dollars ($73,000 U.S. dollars) even after accounting for the cost of implementing the CL service.
This study is important as an initial step in determining the benefits of providing addiction consultation/liaison (CL) services in a medical hospital.
One seemingly logical next step is to test a semi-structured addiction consultation/liaison (CL) intervention in a randomized controlled trial against, for example, usual medical care.
Reeve, R., Arora, S., Butler, K., Viney, R., Burns, L., Goodall, S., & van Gool, K. (2016). Evaluating the impact of hospital based drug and alcohol consultation liaison services. Journal of Substance Abuse Treatment.
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