Examining attrition rates at one specialty addiction treatment provider in the United States: a case study using a retrospective chart review
Open accessAbstract
BACKGROUND: Engaging individuals who have a substance use disorder (SUD) in treatment continues to be a challenge for the specialty addiction treatment field. Research has consistently revealed high rates of missed appointments at each step of the enrollment process: 1. between calling for services and assessment, 2. between assessment and enrollment, and 3. between enrollment and completion of treatment. Extensive research has examined each step of the process; however, there is limited research examining the overall attrition rate across all steps. METHODS: A single case study of a specialty addiction treatment agency was used to examine the attrition rates across the first three steps of the enrollment process. Attrition rates were tracked between August 1, 2011 and July 31, 2012. The cohort included 1822 unique individuals who made an initial request for addiction treatment services. Monthly retrospective reviews of medical records, phone logs, and billing data were used to calculate attrition rates. Attrition rates reported in the literature were collected and compared to the rates found at the target agency. RESULTS: Median time between request for treatment and assessment was 6 days (mean 7.5) and between assessment and treatment enrollment was 8 days (mean 12.5). An overall attrition rate of 80% was observed, including 45% between call and assessment, 32% between assessment and treatment enrollment (another 17% could not be determined), and 37% left or were removed from treatment before 30 days. Women were less likely to complete 30 days of treatment compared to men. No other demographics were related to attrition rates. DISCUSSION: One out of every five people who requested treatment completed a minimum of 30 days of a treatment. The attrition rate was high, yet similar to rates noted in the literature. Limitations of the single case study are noted. CONCLUSION: Attrition rates in the U.S. are high with approximately 75% to 80% of treatment seekers disengaging at one of the multiple stages of the enrollment and treatment process. Significant changes in the system are needed to improve engagement rates.
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Conducting research on SUD populations creates additional challenges, as there are often high attrition rates.
“Conducting research on SUD populations creates additional challenges, as there are often high attrition rates (146).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [146]
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- Authors
- Loveland, D., & Driscoll, H.
- Corresponding author
- Loveland, David
- Venue
- Substance Abuse Treatment Prevention and Policy
- Published
- 2014-09-25
- Volume
- 9
- Issue
- 1
- Pages
- 41-41
- ISSN
- 1747-597X (ISSN-L)
- PMC
- PMC4189207
- OpenAlex
- W2096765310
- Cited by
- 47
- References
- 51
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 9 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 6 · 2015: 2
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Substance Abuse Treatment Prevention and Policy (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- treatment discontinuation, addiction treatment, treatment enrollment, missed appointments, treatment engagement
- MeSH terms
- Adult, Female, Humans, Male, Medical Audit, Patient Compliance, Retrospective Studies, United States, Substance-Related Disorders, Organizational Case Studies
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