Alcoholism treatment and medical care costs from Project MATCH
Alcoholism treatment and medical care costs from Project MATCH
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DOI：
10.1046/j.1360-0443.2000.9579993.x
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发表时间：
2000-07-01
期刊：
影响因子：
6
通讯作者：
Zweben, A
中科院分区：
文献类型：
--
作者：
Holder, HD;Cisler, RA;Zweben, A
目标。本文探讨了医疗保健的费用之前和之后开始酗酒治疗的一部分，患者匹配的治疗方式的研究。设计治疗前和治疗后启动的纵向研究。测量.治疗后3年内参与患者的住院和门诊治疗的总医疗费用。设置.在9个项目MATCH地点中的2个（密尔沃基，WI和普罗维登斯，RI）的3个治疗地点。参与者279名患者。干预患者被随机分配到三种治疗模式之一：12个疗程的认知行为治疗（CBT），4个疗程的动机增强治疗（MET）或12个疗程的跨步骤促进（TSF）治疗，为期12周。调查结果。从治疗前到治疗后，每种治疗方式的总医疗费用都有所下降。匹配效果独立于临床预后表明，MET具有潜在的医疗保健成本节约。然而，具有不良预后特征（酒精依赖，精神严重程度和/或饮酒的社会网络支持）的患者使用CBT和/或TSF具有更好的成本节约潜力。结论.匹配变量在增加酗酒治疗后医疗成本降低的潜力方面具有重要意义。
Aims. This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching to treatment modality. Design. Longitudinal study with pre- and post-treatment initiation. Measurements. The total medical care costs for inpatient and outpatient treatment for patients participating over a spall of 3 years post-treatment. Setting. Three treatment sites at two of the nine Project MATCH locations (Milwaukee, WI and Providence, RI). Participants. Two hundred and seventy-nine patients. Intervention. Patients Mere randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral therapy (CBT), a four-session motivational enhancement therapy (MET) or a 12-session Twelve-Step facilitation (TSF) treatment over 12 weeks. Findings. Total medical care costs declined from pre- to post-treatment overall and for each modality. Matching effects independent of clinical prognosis showed that MET has potential for medical-care cost-savings. However, patients with poor prognostic characteristics (alcohol dependence, psychiatric severity and/or social network support for drinking) have better cost-savings potential with CBT and/or TSF. Conclusions. Matching variables have significant importance in increasing the potential for medical-care cost-reductions following alcoholism treatment.