COST EFFECTIVENESS OF DUAL DIAGNOSIS TREATMENT

双重诊断治疗的成本效益

• 批准号: 3387390
• 负责人: GREGORY B. TEAGUE
• 金额: $ 40.93万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-09-30 至 1992-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3387390
• 关键词: caregivers; community mental health services; health care cost /financing; health care model; health care service evaluation; homeless; human subject; human therapy evaluation; interview; mental disorder diagnosis; mental disorders; patient care management; substance abuse related disorder

This proposal seeks to add a cost component to an ongoing study of two approaches to treatment of people who are, dually diagnosed with severe mental illness and substance use disorders. The study compares traditional Community Support Program (CSP) case management with a program that integrates treatment for substance abuse and psychiatric disorders in an assertive case management approach we call Continuous Treatment Teams (CTT). Approximately 230 clients will be randomly assigned to either CSP or CTT and followed over a three-year period to evaluate the relative effectiveness of the two approaches. Because of difficulties associated with co-occurring severe mental illness and substance use disorders, these clients are believed to be particularly high resource users. One goal of the proposed study is to collect accurate client-level data on resource use. By combining data on resource use at several points in time with the extensive data on effectiveness that are already being collected as a part of the original study, we will be able to compare the cost-effectiveness of the two approaches over time. We hypothesize that total resource use by CTT clients will decrease over time, even though the initial investment per patient may be greater than that of the CSP approach, and that CTT will be more cost-effective than CSP within the three-year follow-up period. Measuring resource use and effectiveness at regular intervals allows us to test these hypotheses by tracking changes in cost-effectiveness over time. Questions of community and family burden have become more important as severely mental ill patients spend less time in hospitals and more time at home or in the community. Previous mental health cost studies used indirect methods for estimating community and family costs, measured them incompletely, or failed to measure them at all. In this study we will improve on existing techniques for documenting use of community and family resources. We will use newly developed client and family interviews to capture these costs more accurately. We hypothesize that CTT clients will use fewer family and community resources than CSP clients during the follow-up period.

该提案旨在为正在进行的两项研究添加成本组成部分 双重诊断患有严重疾病的人的治疗方法 精神疾病和物质使用障碍。 研究比较 传统的社区支持计划 (CSP) 案例管理与计划 将药物滥用和精神疾病的治疗结合起来 我们称之为“持续治疗团队”的自信病例管理方法 （CTT）。 大约 230 名客户将被随机分配到任一 CSP 或 CTT，并在三年内进行跟踪以评估相对 两种方法的有效性。 由于相关困难 伴随着严重的精神疾病和药物滥用障碍的同时发生，这些 客户被认为是特别高的资源使用者。其中一个目标是 拟议的研究是收集准确的客户级资源数据 使用。 通过将多个时间点的资源使用数据与 已作为一部分收集有关有效性的大量数据 根据原始研究，我们将能够比较成本效益 随着时间的推移，这两种方法的效果。 我们假设资源使用总量 CTT 客户的投资将随着时间的推移而减少，即使初始投资 每名患者的治疗费用可能大于 CSP 方法，并且 CTT 后续三年内将比CSP更具成本效益 时期。 定期衡量资源使用情况和有效性 允许我们通过跟踪变化来检验这些假设 随着时间的推移，成本效益。 社区和家庭负担问题变得更加重要 严重精神病患者在医院的时间更少，而在医院的时间更多 家里或社区。 使用之前的心理健康成本研究 估算社区和家庭成本的间接方法，并对其进行测量 不完整，或者根本没有测量它们。 在本研究中我们将 改进记录社区和家庭使用情况的现有技术 资源。 我们将使用新开发的客户和家庭访谈来 更准确地捕获这些成本。 我们假设 CTT 客户会 与 CSP 客户相比，在治疗期间使用更少的家庭和社区资源 随访期。