The relation between different definitions of dropout and the number of dropouts in Norway

Dropout has a range of adverse consequences. As an indicator of the quality of treatment, it may have an economic and organizational consequence for treatment organizations and clinics. Stable, precise, and comparable dropout definitions across SUD treatment settings and stakeholder functions are important. This study investigates how controlling for a set of variables influences the dropout rates when added to a health authority codex definition that is based on the transactional aspect of the termination.

The participants (N = 587) in this study were inpatients between 2012 and 2015 in SUD-treatment. Treatment termination, primarily adheres to the Norwegian health authorities’ official codex that defines six termination categories, were combined with definitions of dropout and information of whether the patient had adequate housing, work or organized daily activities, type of income, a plan of how to spend pastime, whether appointments were made with municipal social services where the patients were to move, and if the patients were using substances.

We found that the use of different definitions of dropout changed the number of dropout cases. The health authority standard definition of dropout produces the lowest dropout rates. As coding of dropouts is mandatory it is crucial that the same definition is applied, especially since the number of dropouts is applied as an indicator of the quality of the treatment given in the SUD facilities by the Norwegian government. Most treatment clinics strive to have the lowest possible number of dropouts. Treatment goals the patient has reached could be a more accurate definition of dropout.