Date of Award

1-1-2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Melissa Weimer

Abstract

Objective: Little is known about the association of sex and racial differences in accessing SUD treatment. little is known whether these disparities continue despite hospitalization. The main objective was to determine the association of race and sex differences on 30-day retention in addiction treatment for all substance use disorders after discharge. Design: A Retrospective Cohort Study using the Yale Addiction Medicine Consult Service databaseSubjects: Patients with SUD who were hospitalized at Yale New Haven Hospital from Oct 26th, 2018 to Jun 30th, 2021 are eligible, which has 2557 observations. Methods: Mixed effect multivariable logistic regression for sex and racial differences on attending 30-day retention addiction treatment after discharge, which involves predictors: gender, race, age, ethnicity, history of medication treatment, housing status, transportation, length of stay, primary substance use disorder, infective endocarditis, and HCV. Results: No association of sex(ORs 1.2, 95%CI 0.92-1.57, p=0.18) and race (ORs 1.33, 95%CI 0.96-1.84, p=0.08; ORs 0.60, 95%CI 0.26-1.40, p=0.24) differences on attending 30-day retention addiction treatment in the multivariable model. However, for the bivariate model, both history medication treatment and primary substance use disorder show a statistically significant association with attending treatment. The covariate of history medication treatment and primary substance use disorder could be the primary contributor to the race differences in retention treatment. Conclusion: There is no significant association between sex differences and attending 30-day retention treatment. Future studies are necessary to understand how patients are influenced by the history of medication treatment and primary substance use disorder, and the effectiveness of SUD hospitalization treatment in addressing disparity is also meaningful to study.

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