COST OF HEALTH CARE FOLLOWING ALCOHOL TREATMENT

申请者摘要：当前医疗政策和医疗改革努力 强调管理性保健是改善服务质量的主要机制 酒精/其他药物滥用(AOD)治疗的成本效益。一些 然而，关于管理型医疗的绩效，有经验数据可用 这片区域。人们对AOD治疗的成本效益知之甚少 在管理型医疗设置中。 这项研究的主要目的是确定AOD治疗是否会影响 大型管理型医疗服务中的后续医疗服务利用率和成本 布景。研究地点为西北分部Kaiser Permanente(KPNW) 一个团体模型HMO，为超过40万名成员提供服务。与许多托管服务不同 护理计划，KPNW以最低限度的费用提供全面的AOD治疗服务 护理方面的经济障碍。 具体目标：1)评估卫生服务模式的变化 AOD治疗后的利用率和成本，并确定 更大的成本降低与治疗量和更好的 治疗结果；以及2)确定卫生服务的趋势 使用率和成本在评估和建议的人员之间有所不同 AOD治疗组和未发现AOD问题的对照组。这个 主要的研究假设是，AOD的治疗量将与 与随后使用保健服务和费用有关。 这项研究克服了过去研究的许多缺点。它包括 大量研究对象-被诊断为AOD问题的人和 推荐用于治疗，但在数量上有相当大的差异 接受的治疗--人口统计学上相似但 不知道有酒精和毒品问题，最多三年前和 三年后评估的利用和费用措施。最后， 对AOD诊断、问题严重性、医疗条件和 以前的医疗使用情况，并包括以下AOD结果的测量 治疗。

APPLICANT'S ABSTRACT: Current health policy and health care reform efforts emphasize managed care as a primary mechanism for improving the delivery and cost-effectiveness of alcohol/other drug abuse (AOD) treatment. Few empirical data are available, however, on the performance of managed care in this area. Not much is known about the cost effectiveness of AOD treatment in managed care settings. The main purpose of this study is to determine whether AOD treatment affects subsequent health care utilization and costs in a large managed care setting. The study setting is Kaiser Permanente, Northwest Division (KPNW), a group model HMO, that serves over 400,000 members. Unlike many managed care plans, KPNW provides comprehensive AOD treatment services with minimal financial barriers to care. The specific aims: 1) assess changes in patterns of health services utilization and costs following AOD treatment and to determine whether greater cost reductions are associated with amount of treatment and better treatment outcomes; and 2) to determine whether trends in health services utilization and costs differ between persons assessed and recommended for AOD treatment and a comparison group not known to have AOD problems. The major study hypothesis is that amount of AOD treatment will be inversely related to subsequent use of health care services and costs. The study overcomes many of the shortcomings of past research. It includes a large number of study subjects-persons diagnosed with an AOD problem and recommended for treatment, but with considerable variation in amount of treatment received--a comparison group that is demographically similar but not known to have alcohol and drug problems, and up to three-year pre- and three-year post-assessment measures of utilization and costs. Finally, the study controls for AOD diagnosis, problem severity, medical conditions, and prior medical utilization, and includes measures of AOD outcomes following treatment.