Peer Support Services for Substance Use Disorders May Reduce Acute Care Utilization

Peer support services for substance use disorders (PS SUD) are increasingly in use and may improve health outcomes. Researchers conducted a case-control study of health service utilization comparing Pennsylvania Medicaid enrollees with at least two paid claims for PS SUD services (n=349) who were also receiving outpatient SUD treatment, with a group of patients receiving outpatient SUD services without PS SUD (n=698). Both groups utilized acute care (hospitalization or withdrawal management) in the 90 days prior to enrollment.

• The PS SUD cohort had decreased acute care utilization compared with the outpatient SUD cohort, both during enrollment (9 percent versus 21 percent, respectively), and 90 days post-enrollment (14 percent versus 17 percent).
• Patients receiving PS SUD had increased use of ancillary outpatient services (including rehabilitation and halfway housing), compared with those receiving outpatient SUD services-alone, both during enrollment (rehabilitation: 20 percent versus 16 percent; halfway housing: 20 percent versus 7 percent), and 90 days post-enrollment (rehabilitation: 19 percent versus 15 percent; halfway housing: 12 percent versus 8 percent).
• The proportion of patients continuing outpatient SUD treatment was higher 90 days post-enrollment in the PS SUD group (45 percent) than in the outpatient SUD group (0 percent).

Comments: In a high-risk patient population with SUD hospitalization in the last 90 days, receipt of PS SUD was associated with decreased acute care utilization and increased sustained engagement with outpatient SUD services, compared with patients who received only outpatient SUD services. Peer support services may help high-risk patients navigate outpatient resources and avoid acute decompensation or hospitalization.

Brigid Adviento, MD, MPH* & Darius A. Rastegar, MD

* 2023–24 Rich Saitz Editorial Intern & Addiction Medicine Fellow, University of Iowa Hospitals and Clinics

Reference: Hutchison SL, MacDonald-Wilson KL, Karpov I, et al. Peer support to reduce readmission in Medicaid-enrolled adults with substance use disorder. J Subst Abuse Treat. 2023;144:108901.