Hospitals play a critical role in the substance abuse services they provide and also in their ability to connect patients with local treatment and harm reduction services, said scientists.

‘Hospital size may affect a hospital's perception of its ability to afford an opioid program, while the effect of county income levels could reflect that "hospitals are more likely to offer these services if they are more confident in their patients' ability to pay. ’

The study analyzed data for 3,365 acute-care hospitals across the country, from the 2010 and 2015 installments of the American Hospital Association Annual Survey. In the time between the two surveys, it found, these hospitals showed a net loss of in-patient and out-patient opioid-related programs, even as overdose deaths continued to climb. 




While some hospitals added programs during this period, a greater number discontinued them. In 2010, a total of 334 hospitals surveyed offered in-patient services and 588 offered out-patient services, but by 2015 these numbers had dropped to 327 and 577, respectively.
"Hospitals are actually backing away from these services even while we have this discussion of an epidemic and the need for services for that," noted author Cronin. That could spell problems for patients with drug dependency, Franz added.
"We need to better understand how to support hospitals, especially in rural areas, to participate in the local opioid service infrastructure."
Why are hospitals shedding opioid programs? The paper reviews some of the more important factors that may influence a decision on whether to add, drop or continue such programs. Factors that make a hospital more likely to offer them include having more beds (larger size); being nonprofit or having a religious affiliation; being in a county with higher household income; and being in a county designated Appalachian. Hospitals are less likely to provide such substance-abuse services when their home county contains a psychiatric facility.
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That having a psychiatric facility in its county makes a hospital less likely to offer opioid services, the study argues, may indicate that "if other local entities exist, hospitals may not see offering substance abuse disorder services as their responsibility beyond stabilizing acutely ill patients in the emergency room." And the fact that Appalachian counties are less likely to have such psychiatric facilities may account for hospitals in those counties being more apt to offer drug programs.
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Source-Eurekalert