ALCOHOL ABUSE TREATMENT OUTCOMES IN MANAGED CARE

管理式护理中的酒精滥用治疗结果

• 批准号: 2539521
• 负责人: ROBERT L. KANE
• 金额: $ 24.3万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-30 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2539521
• 关键词: alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; data collection methodology /evaluation; health care cost /financing; human data; human subject; human therapy evaluation; longitudinal human study; managed care; outcomes research; primary care physician; psychometrics; statistics /biometry; substance abuse related disorder

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).

申请人的摘要：我们将借鉴结果的存在 与国家行为共同开发的信息系统 托管护理组织评估治疗方面的变化影响 有关各种功能结果和成本的方法和具体策略。 我们将在6、12和18的大约2700个病例上收集功能结果 月份。我们将分析患者特征在 解释治疗结果（特别检查 作为治疗有效性分析的一部分，停止治疗）。 使用从管理记录中获取的特殊调查信息和数据， 我们将分析提供商特征的贡献（例如， 培训，经验，酒精/药物滥用历史）和贡献 治疗方法（例如，会话的数量和类型和持续时间 治疗）在解释功能治疗结果时（即其他 比费用）。使用，完整的数据集（具有基线量度和 利用数据），我们将计算医疗和酒精/药物滥用 酒精，酒精/药物滥用治疗的成本以及所有人的成本 通过分析MCC及其家长Cigna索赔数据来治疗。 我们将估计患者各种措施之间的关系 特征，包括基线功能状态以及每个特征 结局度量，使用各种形式的回归。这些回归将会 当结果变量表示为一个时，请使用后勤形式 连续的二分变量和OLS（普通最小二乘） 变量。我们将使用这些分析作为测试的基础 通过将它们添加到各种处理变量的解释能力中 不同组合中的预测方程。最后，我们将测试 客户特征和治疗之间的相互作用的潜力。这 建议的分析将检查三组使用和支出变量： （1）所有酒精/药物滥用服务的使用/支出； （2） 使用/支出所有酒精/药物滥用相关服务（包括， （1）中的那些； （3）所有服务的使用/支出。我们将检查 最后两个查看酒精/药物滥用的治疗 类型通过改变医疗模式而部分或完全抵消。 我们区分酒精/药物滥用相关成本和总数 医疗保健费用是因为与所有医疗保健使用的因果关系是 较弱，并且由于人们担心总噪音的增加 数字。结果，我们预计（3）类别中的精度降低（所有健康状况 医疗费用）比我们（1）（酒精/药物滥用治疗）所做的 或（2）（使用/支出与酒精/药物滥用相关服务）。