Timing of initial post-discharge walk-in bridge clinic visit and outpatient linkage to care in opioid use disorder

ABSTRACT

Introduction: Opioid use disorder (OUD) bridge clinics are used as temporary post-discharge “bridges” for OUD treatment after hospital or emergency department (ED) discharge while patients wait to obtain a regular outpatient provider. The objective of this study was to assess whether an earlier initial follow-up after discharge in a walk-in-based OUD bridge clinic is associated with increased linkage to outpatient OUD treatment.

Methods: This was a retrospective cohort study of patients (N = 165, 66% male) referred to a single walk-in, urgent care center-based OUD bridge clinic within a county safety-net hospital system after hospital or ED discharge. A modified Poisson regression model with a log link and robust standard errors was used to estimate adjusted risk ratios and 95% confidence intervals.

Results: There was no significant association between the time until a patient’s first OUD bridge clinic visit after referral at hospital or ED discharge and eventual linkage to outpatient OUD treatment (unadjusted RR, 1.00; 95% CI, 0.99–1.01; p = 0.84).

Discussion: Our study contrasts with previous studies showing that earlier appointments after discharge improve linkage to care among patients with OUD. This may suggest that the walk-in structure of our bridge clinic attenuates the negative impact of delays in follow-up care by allowing patients to present according to their readiness and availability.

Keywords: Buprenorphine, opioid use disorder, bridge clinic, post-discharge, follow-up