UTILIZATION, COST EVALUATION--PATIENT-TREATMENT MATCHING

这项研究提出了一个成本效益的研究匹配和 随机分配接受酒精中毒治疗的患者（12- 阶梯促进;认知行为治疗;动机 增强）。通过比较客户的医疗保健利用率和成本， 治疗前12个月与治疗期间发生的事件， 在治疗后的36个月内，成本评估研究将 确定适当患者与治疗相匹配的美元成本影响 条件项目MATCH的9个临床研究单位（CRU）中的2个 将与PIRE研究人员合作进行成本效益研究- 威斯康星州CRU（200例门诊病例和75例术后护理病例）和 Brown CRU（200个善后护理案例）。将招募475名客户 作为研究对象。除了基本的MATCH协议之外， 包括入学时的面试，在完成三个月的 治疗后第一年每三个月 完成的，成本抵消研究受试者将被要求（1）提供更多 详细回顾其医疗保健利用情况，（2） 每三个月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， (two超过计划的MATCH患者随访数年），和（3） 授权释放健康保险或医疗保健提供者的记录 包含与卫生保健利用相关的成本。为了布朗 CRU、详细的医疗保健利用和延长的随访期 作为单独的 补充NIAAA资助的R 09研究，因此只有PIRE随访健康 提供者或保险索赔记录的护理费用已添加到 布朗CRU的研究分析供应商和索赔记录将 更准确地确定诊断、发生日期和费用 相关的医疗保健使用的成本抵消匹配研究。 成本效益分析将计算净利润和边际利润 降低与匹配和不匹配相关的医疗保健成本。 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.