MEDICAL VS SOCIAL MODEL DAY TRERTMENT--OUTCOME AND COST

医疗与社会模式日间治疗——结果和成本

• 批准号: 2849434
• 负责人: Lee A Kaskutas
• 金额: $ 26.98万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-25 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2849434
• 关键词: alcoholic beverage consumption; alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; clinical trials; family structure /dynamics; health care cost /financing; health care model; health care service evaluation; health care service planning; health care service utilization; health services research tag; human subject; human therapy evaluation; longitudinal human study; outcomes research; outpatient care; social model; social support network; statistics /biometry

APPLICANT'S ABSTRACT]: As increasing numbers of individuals enter treatment for alcohol dependence and abuse, an era of cost containment in health care challenges the cost effectiveness of traditional inpatient treatment. Clinical studies suggest that outpatient treatment for alcohol abuse and dependence may be as effective as inpatient treatment, and day hospital medical model programs have become a prominent outpatient modality. However, medical model programs are in general more expensive than non-clinical orientations such as the social model approach, although the effectiveness and cost of medical versus social model day treatment have not been assessed. Given the range and severity of problems commonly found among alcohol treatment clients, a question remains of what is the optimum approach for rehabilitation and whether this differs by gender, ethnicity, and psychiatric comorbidity. This study undertakes a controlled, random assignment comparison of two approaches to day treatment--the medical model and the social model--in "real world" agencies serving a heterogenous population (N=300; 28% women, 33% African American, and 33% Hispanic) reflective of many urban communities of individuals seeking help for their drinking. Using an intent to treat model, the study compares the effects of day medical model treatment and day social model treatment during the course of the care provided. It investigates differences in the approach taken to substance abuse treatment at the two programs, including the number and content of scheduled activities and services received, the role of staff, and areas stressed by the respective orientations. It compares post-treatment outcome and improvement rates in the areas of abstinence and alcohol consumption and drug use, levels of medical and psychiatric problems, levels of employment, legal and family/social problems, and supportiveness of social networks towards abstinence, and considers utilization of corresponding health and social services. The study aims to identify patient characteristics associated with successful treatment outcomes in each program orientation, and aspects of treatment associated with improvement at six and 12 months post-treatment. Finally, it compares the costs of day medical model and day social model treatment, and assesses relative cost and effectiveness of the two programs.

申请人摘要]：随着越来越多的人进入治疗 对于酒精依赖和滥用，医疗保健成本控制的时代 挑战传统住院治疗的成本效益。 临床研究表明，酗酒的门诊治疗和 依赖可能与住院治疗和日间医院一样有效 医学模式项目已经成为一种重要的门诊模式。 然而，医学模型项目通常比 非临床导向，如社会模型方法，尽管 医疗模式日治疗与社会模式日治疗的有效性和成本没有 被评估过了。考虑到常见问题的范围和严重性 在酒精治疗的客户中，还有一个问题是什么是最好的 康复的方法，以及这是否因性别、种族、 和精神疾病共病。本研究进行了一项对照、随机、 两种日间治疗方法的分配比较--医学模式 以及社会模式--在“现实世界”中，机构为异质的 人口(N=300；女性占28%，非裔美国人占33%，西班牙裔占33%) 反映了许多城市社区的个人为他们的 喝酒。使用意向治疗模型，该研究比较了 疗程中的日间医学模式治疗和日间社会模式治疗 所提供的护理。它调查了采取的方法的差异 两个方案的药物滥用治疗，包括人数和 所收到的预定活动和服务的内容、工作人员的作用、 以及各自方向所强调的领域。它比较了 戒酒和戒酒领域的治疗后结果和改善率 酒精消费和药物使用，医疗和精神疾病水平 问题、就业水平、法律和家庭/社会问题，以及 社交网络对禁欲的支持，并考虑 利用相应的卫生和社会服务。这项研究旨在 确定与成功治疗相关的患者特征 每个方案方向的结果以及相关治疗的各个方面 治疗后6个月和12个月均有改善。最后，进行了比较。 日间医疗模式和日间社会模式治疗的成本，并进行评估 两个方案的相对成本和有效性。