The natural history of outpatient alcohol and drug abuse treatment in a private healthcare setting.
The natural history of outpatient alcohol and drug abuse treatment in a private healthcare setting.
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私人医疗机构中门诊酒精和药物滥用治疗的自然史。
DOI：
10.1111/j.1530-0277.1996.tb05262.x
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Jensen,JM
中科院分区：
文献类型：
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作者：
Pettinati,HM;Belden,PP;Evans,BD;Ruetsch,CR;Meyers,K;Jensen,JM
管理式医疗保健对私人环境中酒精和药物滥用治疗服务的提供产生了重大影响，主要是通过将患者从住院治疗计划转移到门诊治疗计划。本研究的目的是调查在一个私人的，非营利的医疗机构门诊酒精和药物滥用治疗的自然史。在120例DSM-III-R诊断为酒精和/或可卡因依赖的患者中，评价了治疗前的患者特征、6周门诊计划的出勤记录以及治疗后一年的结局。有70名门诊患者成功完成了该计划，50名没有完成。门诊治疗失败的两个亚型被确定：Ss谁过早离开治疗的医疗建议（n = a），和Ss谁参加了治疗，但继续大量使用的物质（治疗耐药，n= 27）。Logistic回归分析显示，年龄较小、多次既往治疗和就业问题与门诊治疗失败有关。门诊失败的患者没有立即寻求替代治疗，他们中的大多数人在治疗后一年继续使用大量药物，即，82% vs. 43%成功完成（X2= 13.8，df = 1，p < 0.01）。因此，有临床相关数量的门诊失败（42%），无论是因为缺乏程序出席或继续使用物质在整个治疗这些行为是与继续大量使用物质在治疗后的一年
Managed healthcare has had a major impact on the delivery of alcohol and drug abuse treatment services in the private setting, primarily by shitting patient enrollment from inpatient to outpatient treatment programs. The purpose of this study was to investigate the natural history of outpatient alcohol and drug abuse treatment in a private, nonprofit healthcare setting. Patient profiles at pretreatment, their attendance record in a 6‐week outpatient program, and their outcome in the year after treatment were evaluated in 120 patients with a DSM‐III‐R diagnosis of alcohol and/or cocaine dependence. There were 70 outpatients who successfully completed the program, and 50 who did not. Two subtypes of outpatient treatment failures were identified: Ss who prematurely left treatment against medical advice (n = a), and Ss who attended treatment but continued heavy use of substances (Treatment Resistant,n= 27). A logistic regression revealed that younger age, multiple prior treatments, and employment problems were related to outpatient treatment failure. Outpatient failures did not immediately seek alternative treatment, and most of them continued heavy substance use in the year post‐treatment i.e., 82% vs. 43% successful completers (X2= 13.8,df= 1, p < 0.01). Thus, there were a clinically relevant number of outpatient failures (42%), either because of lack of program attendance or continued substance use throughout treatment These behaviors were related to continued heavy use of substances in the year after treatment