Preventing Hospital Readmission for Patients with Comorbid Substance Use Disorder: A Randomized Trial

Jan Gryczynski
Courtney D. Nordeck
Christopher Welsh
Shannon G. Mitchell
Kevin E. O’Grady
Robert P. Schwartz
Peer-Reviewed Article
April 2021


Personalized patient navigation supports for people with comorbid substance use disorders reduced rates of hospital readmissions and emergency department use.


Individuals with substance use disorders (SUD), who often have co-occurring medical and social challenges, are at high risk of hospital readmission, emergency department use, and post-discharge mortality. Many hospitals offer specialty addiction consultation services to meet patient needs, but patients also need improved access to follow-up care. This randomized controlled trial evaluates Navigation Services to Avoid Rehospitalization (NavSTAR), an intervention to reduce acute care use among patients seen by a hospital addiction consultation service that provides proactive case management or care coordination, including linkage to community resources for addressing social needs.


Compared to the cohort of patients who only received routine hospital addiction consultation services, hospitalized adults with comorbid SUDs who received routine care plus the NavSTAR intervention (n=400) experienced reduced rates of hospital readmissions and emergency department use over a 12-month period. NavSTAR recipients were also more likely to enter community SUD treatment within three months of discharge and reported higher levels of adherence to medical instructions.


Personalized navigation services that support SUD-related goals and social needs for patients with comorbid SUDs can improve patient outcomes and lessen acute care use.

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