Health-related quality of life measures as predictors for recurrent hospitalization and mortality among patients in heroin-assisted treatment.

purposeIndividuals with opioid use disorder face complex health needs often necessitating hospital-based care, and many reported low health-related quality of life (HRQoL). This study assessed HRQoL factors as predictors of recurrent hospital-based care and mortality among heroin-assisted treatment (HAT) patients, identified patient groups with distinct HRQoL trajectories, and compared their hospital contact hours and mortality rates with the general population.

methodsA longitudinal cohort study was conducted, involving 541 HAT patients in Denmark from 2010 to 2018, along with a matched sample from the general Danish population. Using recurrent event regression and latent class growth analysis, we analyzed predictors of recurrent hospitalization and established trajectory groups. HRQoL was assessed using the 36-Item Short Form Health Survey (SF-36) and linked to multiple national registry data which provided demographic variables, hospital utilization, and mortality data.

results“General health” emerged as the largest and only significant predictor of recurrent hospitalization. Mortality was predicted by age and ‘role limitations due to emotional problems’. We identified four trajectory groups based on “general health ”, showing either a decreasing or stable trajectory. Groups differed significantly in terms of average hospital contact hours and mortality and all groups had lower ‘general health’ scores and greater mortality than the representative Danish sample. The most severe group had four times higher usage of hospitalization hours.

conclusionSF-36 ‘general health’ is a key risk stratification tool for HAT patients predicting outcomes like hospitalization and mortality. Identifying high-risk individuals can help clinicians implement timely (somatic) care, particularly for long-term patients.