OUTCOME OF DOMICILIARY CARE AFTER INPATIENT ALCOHOLISM-TREATMENT IN MALE VETERANS

Current literature is ambiguous as to the impact of extended treatment services following hospitalization on outcomes such as abstinence. This study compares the outcomes of care for 276 veterans who completed inpatient treatment for alcoholism, 77 of whom (28%) were transferred to a domiciliary and the remainder of whom were discharged directly into the community. The domiciliary group of alcoholics differed at baseline from alcoholics discharged to the community with significantly higher psychiatric comorbidity and lower social support, both negative predictors of treatment outcome. A multiple logistic regression model was used to assess the impact of domiciliary placement on: (a) 3-month abstinence comparing the time after discharge from either the domiciliary or the inpatient treatment unit and (b) 12-month abstinence after discharge from the inpatient treatment unit, including patients placed in the domiciliary. Controlling for baseline differences, domiciliary placement was found to be a significant predictor of abstinence (odds ratios of 2.3 for 3-month and 2.5 for 12-month abstinence, p less than or equal to 0.01). In a survival analysis, domiciliary placement was also a significant predictor of time to readmission after treatment discharge with a risk ratio of 0.2 (p < 0.01). Our results demonstrate a protective effect of domiciliary aftercare for high risk alcoholics after inpatient treatment.