Objective:

To examine the causal relationship between the implementation of an Addiction Consultation Service (ACS) and changes in hospital length-of-stay and 30-day readmission rates for patients with opioid use disorder (OUD).

Approach:

• Study Setting: Conducted at a large academic health system in Philadelphia, PA, including four urban hospitals.
• ACS Implementation: ACS pilot launched in April 2023, fully scaled by July 2023, focusing on multidisciplinary care for patients with OUD.
• Data Collection: Utilized Epic electronic health record data from January 1, 2018, to December 31, 2024, for patient demographics and hospital utilization.
• Outcome Measures: Primary outcomes were hospital length-of-stay and 30-day readmission rates; secondary outcomes included MOUD initiation and discharge practices.

Key Findings:

• ACS implementation is associated with increased rates of MOUD initiation and treatment linkage after discharge.
• Concerns exist regarding potential increases in hospital length-of-stay and readmission rates due to the time required to introduce and titrate MOUD to maximum efficacy.

Interpretation:

The study aims to provide rigorous evidence on the impact of ACS on hospital utilization metrics for patients with OUD.

Limitations:

• The study is limited to a single health system, which may affect generalizability.
• Potential confounding factors related to patient demographics and insurance status were not fully addressed.

Conclusion:

The findings will contribute to understanding the financial and operational implications of ACS in managing OUD in hospital settings.