Predictors of length of treatment, discharge reason, and re-admission to Aboriginal alcohol and other drug residential rehabilitation services in New South Wales, Australia

Journal article


James, Doug B., Lee, K. S. Kylie, Dronavalli, Mithilesh, Courtney, Ryan J., Conigrave, Katherine M., Conigrave, James H. and Shakeshaft, Anthony. (2022). Predictors of length of treatment, discharge reason, and re-admission to Aboriginal alcohol and other drug residential rehabilitation services in New South Wales, Australia. Drug and Alcohol Review. 41(3), pp. 603-615. https://doi.org/10.1111/dar.13388
AuthorsJames, Doug B., Lee, K. S. Kylie, Dronavalli, Mithilesh, Courtney, Ryan J., Conigrave, Katherine M., Conigrave, James H. and Shakeshaft, Anthony
Abstract

Introduction
Aboriginal clients accessing Aboriginal community-controlled residential alcohol and other drug rehabilitation services in New South Wales, Australia believe they have better outcomes due to culturally appropriate care. However, there is a paucity of published treatment outcome data. This study aims to identify predictors of treatment outcomes based on client characteristics at intake.

Methods
A cross-sectional, retrospective, observational study of 2326 admissions to six services between January 2011 and December 2016. The outcomes were: (i) leaving treatment early; (ii) self-discharge or house discharge (by staff); and (iii) re-admission within two years. The predictors examined were Aboriginal status, age, justice system referral and primary substance of concern. Competing risk and Poisson regression analyses were used to identify trends in the data.

Results
The mean age of clients was 33 years, and the majority (56%) stayed at least 6 weeks. Aboriginal clients whose primary substance of concern was stimulants were almost eight times more likely to re-admitted within 2 years than other clients (risk ratio 7.91; P < 0.001). Aboriginal clients who were also referred from justice were more likely to self-discharge (risk ratio 1.87; P < 0.001). Furthermore, Aboriginal clients who were aged older than 30 were less likely to have a re-admission (risk ratio 0.32; P ≤ 0.001).

Discussion and Conclusions
This study showed client characteristics that are predictive of harmful outcomes include age under 30, justice client, primary substance of use and their interactions. Future research could build on these results to aid ongoing development of residential rehabilitation programs for Aboriginal peoples.

KeywordsAboriginal; Australia; residential rehabilitation; predictor; treatment
Year2022
JournalDrug and Alcohol Review
Journal citation41 (3), pp. 603-615
PublisherWiley
ISSN0959-5236
Digital Object Identifier (DOI)https://doi.org/10.1111/dar.13388
PubMed ID34644427
Scopus EID2-s2.0-85116894391
Open accessPublished as green open access
Page range603-615
FunderNational Health and Medical Research Council (NHMRC)
Author's accepted manuscript
License
All rights reserved
File Access Level
Open
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online13 Oct 2021
Publication process dates
Accepted04 Sep 2021
Deposited04 Jul 2023
Grant ID1117198
1148497
117582
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