Patients with substance use disorders (SUD) often experience frequent hospitalizations, early discharges, and elevated rates of readmission shortly after discharge. The COVID-19 pandemic further interrupted addiction treatment services, increasing the risks faced by hospitalized individuals. Understanding inpatient factors associated with lower 30-day readmission rates could inform strategies to enhance post-discharge outcomes in this vulnerable population. We retrospectively examined adults with substance use disorders admitted to Penn State Health Hershey Medical Center from January 1 to December 30, 2021, who received addiction medicine consultations. Information on patients’ social, clinical profiles, and demographic was collected from electronic health records. We used logistic regression to explore how addiction-focused interventions—including counseling, initiation of pharmacotherapy, and referrals—were associated with 30-day all-cause readmission, controlling for factors such as sex, age, insurance coverage, marital status, and comorbidities. Out of 561 patients (average 62% male; age 42 years), 139 (25%) were readmitted within 30 days. Nearly half of the cohort had a diagnosis of depression or anxiety (44%), and 42% reported polysubstance use. Single patients and those with at least one comorbidity were more likely to be readmitted, with adjusted odds ratios (aOR) of 2.41 (95% CI, 1.06–5.45; P = .035) and 2.82 (95% CI, 1.45–5.52; P = .002), respectively. Participation in educational counseling was associated with a significantly lower likelihood of readmission (95% CI, 0.31–0.90; aOR, 0.53; P = .02), while starting addiction-related medications showed a non-significant trend toward reduced readmission risk (95% CI, 0.32–1.21; aOR, 0.62; P = .16). Conversely, patients who left the hospital against medical advice had more than three times the odds of readmission (95% CI, 1.36–6.73; aOR, 3.02; P = .007). Among hospitalized patients with substance use disorders, engagement in addiction-focused interventions during admission was linked to a notable reduction in 30-day readmissions. Both educational counseling and initiation of pharmacotherapy were associated with decreased readmission risk, while patients who left the hospital against medical advice faced substantially higher odds of returning. These results highlight the importance of incorporating structured addiction consultation services to enhance post-discharge outcomes and help prevent avoidable hospitalizations.
