ALCOHOL ABUSE TREATMENT OUTCOMES IN MANAGED CARE

申请人摘要：我们将利用一个结果的存在 信息系统与国家行为准则联合开发 管理保健组织，以评估治疗变化的影响 关于各种功能结果和成本的方法和具体战略。 我们将在6、12和18天收集大约2700例患者的功能结果 月份。我们将分析患者特征在 解释治疗结果(特别是检查 将停止治疗作为治疗效果分析的一部分)。 利用特别调查信息和行政记录中的数据， 我们将分析提供商特征的贡献(例如， 培训、经验、酗酒/药物滥用史)和贡献 治疗方法(例如，疗程的数量和类型以及持续时间 治疗)解释功能性治疗结果，(即，其他 而非成本)。使用，完整的数据集(具有基线测量和 使用数据)，我们将计算医疗和酒精/药物滥用 酒精和酒精/药物滥用治疗费用和所有 通过分析MCC及其母公司信诺的索赔数据进行医疗。 我们将评估患者的各种测量之间的关系 特征，包括基线功能状态，以及每个 结果衡量，使用各种形式的回归。这些回归将会 当结果变量表示为 二分变量与连续变量的普通最小二乘 变量。我们将使用这些分析作为测试 通过将各种处理变量添加到 不同组合的预测方程式。最后，我们将测试 潜在的客户特征和治疗之间的相互作用。这个 拟议的分析将审查三组使用和支出变量： (1)所有酒精/药物滥用服务的使用/开支；。(2) 所有与酒精/药物滥用有关的服务的使用/支出(包括， 第(1)项；及(3)所有服务的使用/开支。我们将研究 最后两个看看是否对酒精/物质滥用有特殊的治疗 通过改变医疗模式，部分或全部抵消了这一类型。 我们区分了与酒精/药物滥用相关的成本和总成本 医疗保健成本，因为与所有医疗保健使用的因果联系是 较弱，因为对总体噪音增加的担忧 数字。因此，我们预计第(3)类(所有健康)的精确度较低 护理费用)，而不是(1)(酒精/药物滥用治疗) 或(2)(酒精/药物滥用相关服务的使用/支出)。

APPLICANT'S ABSTRACT: We will draw upon the existence of an outcomes information system developed in conjunction with a national behavioral managed care organization to assess the effects of variations in treatments approaches and specific strategies on various functional outcomes and costs. We will collect functional outcomes on about 2700 cases at 6, 12, and 18 months. We will analyze the contribution of patient characteristics in explaining treatment outcomes (specifically examining the effects of discontinued treatment as part of the analysis of treatment effectiveness). Using special survey information and data taken from administrative records, we will analyze the contribution of provider characteristics (e.g., training, experience, alcohol/substance abuse history) and the contribution of treatment approaches (e.g., number and types of sessions and duration of treatment) in explaining the functional treatment outcomes, (i.e., other than costs). Using, the full data set (with baseline measures and utilization data), we will calculate the medical and alcohol/substance abuse costs of alcohol and alcohol/substance abuse treatment and the costs of all medical treatment by analyzing MCC and its parent CIGNA claims data. We will estimate the relationship between various measures of patient characteristics, including, baseline functional status, and each of the outcome measures, using various forms of regression. These regressions will use the logistical form when the outcome variable is expressed as a dichotomous variable and OLS (ordinary least squares) for continuous variables. We will use these analyses as a base from which to test the explanatory power of various treatment variables by adding them to the predictive equations in different combinations. Finally, we will test the potential for interactions between client characteristics & treatments. The proposed analysis will examine three sets of use and expenditure variables: (1) the use/expenditures for all alcohol/substance abuse services; (2) the use/expenditure of all alcohol/substance abuse related services (including, those in (1); and (3) the use/expenditure of all services. We will examine the last two to see if alcohol/substance abuse treatment of a particular type is partially or fully offset by changing medical treatment patterns. We distinguish between alcohol/substance abuse related costs and total health care costs because the causal linkages to all health care use are weaker and because of a concern over increased noisiness in the aggregate numbers. As a result, we expect less precision in category (3) (all health care expenses) than we do for either (1) (alcohol/substance abuse treatment) or (2) (use/expenditure of alcohol/substance abuse related services).