COST OF HEALTH CARE FOLLOWING ALCOHOL TREATMENT

申请人摘要：当前的卫生政策和卫生保健改革工作 强调管理式护理是改善分娩的主要机制， 酒精/其他药物滥用（AOD）治疗的成本效益。 几 然而，关于管理式护理的绩效， 这方面 我们对AOD处理的成本效益知之甚少 在管理式护理环境中。 本研究的主要目的是确定AOD治疗是否影响 在大型管理式医疗中， 设置. 该研究的背景是凯撒永久，西北部（KPNW）， 一个团体模式的健康维护组织，为超过40万名成员提供服务。 与许多管理 KPNW提供全面的AOD治疗服务， 财务上的障碍。 具体目标：1）评估卫生服务模式的变化 利用率和成本后，AOD处理，并确定是否 更大的成本降低与治疗量有关， 治疗结果; 2）确定卫生服务的趋势 被评估和被推荐的人员之间的利用率和费用不同， AOD治疗组和一个不知道有AOD问题的对照组。 的 主要的研究假设是AOD治疗量将与 与随后使用医疗保健服务和费用有关。 该研究克服了过去研究的许多缺点。 它包括 大量的研究对象-被诊断患有AOD问题的人， 建议治疗，但在相当大的变化量， 接受的治疗--一个人口统计学上相似但 不知道有酒精和毒品问题，长达三年的前， 评估后三年利用率和费用计量。 最后 AOD诊断、问题严重程度、医疗条件的研究对照，以及 既往医疗使用，并包括以下AOD结局指标 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.