Treatment Settings for Alcoholics: A Field Extension

酗酒者的治疗设置：现场扩展

• 批准号: 6929949
• 负责人: ROBERT G RYCHTARIK
• 金额: $ 35.71万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6929949
• 关键词: alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; clinical research; cognition; correctional institutions; drug /alcohol abstinence; drug detection; field study; functional ability; health care service evaluation; health services research tag; hospital patient care; human subject; human therapy evaluation; interview; longitudinal human study; outcomes research; outpatient care; patient care management; patient oriented research; questionnaires; residential care facility

DESCRIPTION (provided by applicant): This health services application is a field replication and extension of our prior work evaluating treatment settings for alcoholics. Our prior research, conducted in a clinical research environment, found that individuals with a more severe problem benefited more from inpatient than outpatient treatment. For all clients, in patient treatment, relative to outpatient, resulted in fewer combined days of residential treatment or incarceration throughout the 18 month follow-up. These findings are important since inpatient care is becoming increasingly scarce due to the perception that less expensive outpatient treatment is equally effective for all individuals. Moreover, in the absence of empirically-derived placement criteria, level of care determinations often appear circular and inefficient (i.e., to enter inpatient treatment one has to fail outpatient first). Our findings suggest that more efficient level of care determinations may be possible. To address these issues further, we propose to test our earlier findings in a community field setting by prospectively matching and mismatching clients based on alcohol involvement level and/or level of cognitive functioning to either inpatient or outpatient care. Clients presenting for treatment at the Downtown Clinic of the Erie County Medical Center (ECMC), Buffalo, NY will be assigned to inpatient need group (based on alcohol involvement and cognitive functioning levels) and, within each group, randomly assigned to either (a) 21 days of inpatient care at ECMC plus six months of continuing outpatient care. Treatment will be the standard treatment received by clients in the respective programs. All clients will be followed over 18 months following admission (12 months post-continuing outpatient care) and evaluated with respect to the primary outcome measures of voluntary abstinent days and days of involuntary abstinence (i.e., incarceration, residential treatment, etc.). Building on our prior work, the proposal aims to contribute to a small but important body of knowledge on efficient and effective client placement criteria.

描述（由申请人提供）： 此健康服务应用程序是我们的 之前的工作是评估酗酒者的治疗环境。我们之前的研究， 在临床研究环境中进行，发现具有 病情较重者住院治疗比门诊治疗获益更多。 对于所有的客户，在病人治疗，相对于门诊，导致 整个2010年住院治疗或监禁的合并天数减少 18个月随访。这些发现很重要，因为住院治疗是 由于人们认为， 门诊治疗对所有人都同样有效。而且在 缺乏基于外科学的安置标准、护理水平 确定常常显得循环和低效（即，进入住院 治疗一个必须失败的门诊第一）。我们的研究结果表明， 可以进行有效的护理水平确定。解决这些 问题进一步，我们建议在社区领域测试我们早期的发现， 通过基于酒精的前瞻性匹配和不匹配客户来设置 参与水平和/或认知功能水平， 门诊护理。在市中心诊所接受治疗的客户 纽约州布法罗的伊利县医疗中心（ECMC）将被分配到 住院患者需求组（基于酒精参与和认知功能 水平），并在每组内随机分配到（a）21天的 ECMC的住院治疗加上六个月的持续门诊治疗。 治疗将是客户在各自的标准治疗 程序.所有客户将在入院后18个月内接受随访（12 持续门诊治疗后3个月），并就 主要结局指标为自愿禁欲天数和非自愿禁欲天数 禁欲（即，监禁、住院治疗等）。基础上 我们以前的工作，该提案旨在为一个小而重要的机构作出贡献， 关于高效和有效的客户安置标准的知识。