Residential rehabilitation treatment outcomes among women in women-only and mixed-gender services: A retrospective study.

Abstract

This study compared treatment outcomes for adult women in residential rehabilitation treatment attending women-only versus mixed-gender services. Using routinely collected data from 32 non-government organisation alcohol and other drug services in NSW, Australia, mixed-effects logistic and linear regressions estimated the association between service types and treatment outcomes. Treatment outcomes included: completion rates and mean differences in aggregate Kessler Psychological Distress scale (K10), Severity of Dependence Scale (SDS) and EUROHIS-Quality of Life 8 (EQoL) scores from baseline to 30 days and 60 days. Among 11,632 treatment episodes from 7862 women (July 2012-June 2024), 60% were completed. Compared to mixed-gender episodes, women-only episodes more frequently reported Aboriginal and Torres Strait Islander women (29% vs 20%), meth/amphetamines as primary substance (46% vs 37%), living alone (33% vs 28%) or alone with children (13% vs 8%) and more recent treatment entry (43% vs 34% in 2020-2024). After adjusting for covariates, women-only episodes had higher odds of completion than mixed-gender episodes (aOR=1.56;95%CI:1.42,1.71). Among 5803 episodes with baseline outcome data, all showed improved K10, SDS and EQoL scores at 30 days (n = 2504) and 60 days (n = 1003) (all p < 0.001), with women-only episodes showing higher EQoL scores at 30 days (adjusted β=0.57;95%CI:0.16,0.98), and 60 days (adjusted β=0.95;95%CI:0.26,1.63). Baseline severity associated with improved K10, SDS and EQoL scores (all p < 0.001). Women characteristics differed between women-only and mixed-gender services. Although improvements were observed across both service types, higher treatment completion rates and modest quality of life improvements suggest additional benefit of women-only services.