Service use and costs for women with co-occurring mental and substance use disorders and a history of violence
Service use and costs for women with co-occurring mental and substance use disorders and a history of violence
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DOI：
10.1176/appi.ps.56.10.1223
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发表时间：
2005-10-01
影响因子：
3.8
通讯作者：
Russell, LA
中科院分区：
文献类型：
--
作者：
Domino, ME;Morrissey, JP;Russell, LA
目的：本研究调查了参加妇女、并存疾病和暴力研究（WCDVS）的同时患有精神健康和物质使用障碍以及有暴力和创伤史的妇女使用一系列服务的12个月费用。该研究比较了WCDVS在门诊和住院环境中对妇女的干预和外部服务的成本——提供全面、综合和创伤知情的服务——与常规护理对照组妇女的成本。该研究还比较了成本与记录的临床结果。方法：对参加WCDVS的2026名妇女（N= 1018）和对照组（N= 1008）的服务使用成本进行了检查。在基线后的3个月、6个月、9个月和12个月对女性进行了采访，询问她们在过去3个月中的任何服务使用情况。这些服务的成本以及间接成本（参与者的时间和交通）通过使用各种来源进行估算。通过使用普通最小二乘回归或两部分模型分析了许多成本估算。结果：在基线后的12个月内，平均参与者的服务使用成本几乎为43,000美元。与对照组相比，干预组的妇女的服务成本较低，总体成本较高，但没有拒绝组间任何成本测量没有差异的原假设。此外，在研究干预之外获得服务的概率没有差异的原假设也没有被拒绝。结论：由于没有发现成本差异，但临床结果有所改善，因此wcddvs提供的干预措施可能比常规护理更有效。
Objectives: This study examined the 12-month cost of the array of services used by women with co-occurring mental health and substance use disorders and a history of violence and trauma who participated in the Women, Co-occurring Disorders, and Violence Study (WCDVS). The study compared costs of the intervention and external services for women in the WCDVS intervention in outpatient and residential settings-which provided comprehensive, integrated, and trauma-informed services with the costs for women in the usual-care comparison group. The study also compared costs with recorded clinical outcomes. Methods: Costs of service use were examined for 2,026 women who participated in the WCDVS (N=1,018) and in the comparison group (N=1,008). Women were interviewed three, six, nine, and 12 months after baseline about any service use in the past three months. Costs for these services, along with indirect costs ( participants' time and transportation) were estimated by using a variety of sources. A number of cost estimates were analyzed by using either ordinary least squares regression or two-part models. Results: The average participant had almost $43,000 in costs related to their service use during the 12 months after baseline. Women in the intervention group had lower service costs and higher overall costs than those in the comparison group, but the null hypotheses of no difference in any cost measure between groups was not rejected. Also, the null hypothesis of no difference in the probability of accessing services external to the study intervention was not rejected. Conclusions: Because no differences were detected in costs but improvements were seen in clinical outcomes, the interventions offered in the WCDVS may be more efficient than usual care.