UTILIZATION, COST EVALUATION--PATIENT-TREATMENT MATCHING

这项研究提出了一项关于匹配和 随机分配到酒精中毒治疗的患者的不匹配(12- 循序渐进；认知行为疗法；动机疗法 增强)。通过比较客户的医疗保健利用率和成本 在治疗前12个月与治疗期间发生的和 在治疗后的36个月中，成本评估研究将 确定适当的患者与治疗匹配的美元成本影响 条件。来自Project Match的九个临床研究单位(CRU)中的两个 将在成本效益研究中与PERE研究人员合作- 威斯康星州CRU(200例门诊病例和75例善后病例)和 棕色CRU(200例)。总共将招募475名客户 作为研究的对象。除了基本匹配协议之外 包括入学时的面试，在完成三个月的 治疗，治疗后第一年每三个月 已完成、成本抵销的研究对象将被要求(1)提供更多 详细回顾他们的卫生保健利用情况，(2) 每三次参加一次延长的后续访谈 在完成治疗后的第二年和第三年的整个月 (比计划的配对患者随访时间晚两年)，以及(3) 授权发布医疗保险或医疗保健提供者记录 包含与医疗保健利用相关的成本。为布朗一家 CRU，详细的卫生保健利用情况和延长的随访期 已经作为单独的 NIAAA资助的R09补充研究，因此只对健康的PERO进行随访 提供者的护理费用或保险索赔记录已添加到 目前布朗CRU的研究。对提供者和索赔记录的分析将 更准确地确定诊断、发生日期和成本 与医疗保健使用相关的成本抵销研究的匹配。 成本效益分析将计算净值和边际 与匹配和不匹配相关的医疗保健成本的降低。 方差分析(ANOVA)，重复移动平均分析 (ARIMA)和计量经济学时间序列分析模型将被用于 随着时间的推移，研究这些影响。

This research proposes a cost-effectiveness study of matching and mismatching for patients randomly assigned to alcoholism treatment (12- step facilitation; cognitive-behavioral therapy; motivational enhancement). By comparing client health care utilization and costs for 12 months prior to treatment with those incurred during treatment and throughout 36 months after treatment, the cost-evaluation study will identify dollar cost implications of proper patient match to treatment condition. Two of nine clinical research units (CRUs) from Project MATCH will collaborate with PIRE researchers in the cost-effectiveness study - the Wisconsin CRU (200 outpatient cases and 75 aftercare cases) and the Brown CRU (200 aftercare cases). A total of 475 clients will be recruited as subjects for the study. In addition to the basic MATCH protocol including interviews at intake, after completion of three months of treatment, and every three months for the first year after treatment is completed, cost-offset study subjects will be asked to (1) provide more detailed retrospective accounts of their health care utilization, (2) participate in an extended follow-up period of interviews every three months throughout the second and third year after completing treatment (two years beyond the planned follow-up of MATCH patients), and (3) authorize release of health insurance or health care provider records containing costs associated with health care utilization. For the Brown CRU, detailed health care utilization and extended follow-up periods have already been implemented for MATCH patients as part of a separate supplemental NIAAA-funded R09 study, so only the PIRE follow-up of health care costs from provider or insurance claim records have been added to the current Brown CRU study. Analysis of provider and claims records will more accurately identify diagnoses, dates of occurrences and costs associated with health care use for the cost-offset study of matching. Cost-effectiveness analysis will calculate the net and marginal reductions in health care costs associated with matching adn mismatching. Analysis of variance (ANOVA), analysis of repeated moving average (ARIMA), and econometric time-series analysis models will be used to study these effects over time.