Family Members of Alcohol Patients Utilization and Cost

酗酒者家庭成员的利用和费用

• 批准号: 6932049
• 负责人: CONSTANCE M. WEISNER
• 金额: $ 23.83万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6932049
• 关键词: age difference; alcoholism /alcohol abuse therapy; clinical research; cost effectiveness; drug /alcohol abstinence; drug addiction; family; gender difference; health care cost /financing; health care facility information system; health care service utilization; health insurance; health services research tag; human subject; human therapy evaluation; income; interview; spouses

DESCRIPTION (provided by applicant): The aim of this study is to investigate the health care utilization and costs, and the medical and psychiatric conditions, for spouses and children of persons admitted to a chemical dependency (CD) program. If family members of CD treatment patients have higher costs and utilization than persons from a general membership sample of families, and if these are affected by CD treatment, this would have implications for the cost-effectiveness of treatment. Few studies have looked at costs and utilization of family members of persons with alcohol or drug problems, and fewer still have been able to assess the effect on them of treatment. We propose to study 3011 family members of 1241 patients who were admitted to treatment at a Northern California Kaiser Permanente (KP) CD recovery program. Extensive interview data, including 5 year treatment outcomes, have been collected on the CD sample. Using KP electronic databases we will collect 6 years of cost, utilization and diagnostic-related data for the family members, as well as for members of a large comparison group of families randomly selected from the general health plan membership. We will investigate whether the spouses and children of the CD patients have higher costs and utilization (and different types of utilization such as inpatient and ER) than the comparison group, after adjusting for age, gender, family size and other individual and family characteristics, and whether treatment outcome affects the cost differences. We will also investigate whether family members of CD patients have heightened medical and psychiatric conditions compared to the comparison group. In investigating the role of treatment outcome on family utilization, we use a model that includes characteristics of: the treatment sample (e.g., demographic and problem characteristics), the family environment (e.g., family stressors and family composition), and treatment (e.g., treatment outcome and readmissions) in their relationship to family members' utilization. We will use linear and non-linear mixed models to investigate cost and utilization differences. These models appropriately handle repeated measures and intra-family correlation, while adjusting for important confounders. Our large sample and wealth of detailed self-report and automated data over a long period of time will allow us to answer important epidemiologic and health policy questions regarding the effect on utilization of having family members with alcohol and drug problems, the medical needs of family members, and the effect on family members of the treatment of those problems.

描述（由申请人提供）：本研究的目的是调查接受化学依赖计划（CD）计划的配偶和子女的医疗保健利用和成本以及医学和精神病条件。如果CD治疗患者的家庭成员比一般家庭成员样本的人的成本和利用率更高，并且如果这些成员受到CD治疗的影响，这将对治疗的成本效益产生影响。很少有研究研究了饮酒或毒品问题的人的成本和利用，并且仍然能够评估对治疗的影响。我们建议研究3011名在北加州Kaiser Permanente（KP）CD恢复计划中接受治疗的患者的家庭成员。 CD样本已收集了广泛的访谈数据，包括5年治疗结果。使用KP电子数据库，我们将为家庭成员收集6年的成本，利用和与诊断相关的数据，以及从一般健康计划成员中随机选择的大型比较家庭的成员。在调整年龄，性别，家庭规模以及其他个人和家庭特征之后以及治疗结果是否影响成本差异。与比较组相比，我们还将调查CD患者的家庭成员的医学和精神疾病较高。在研究治疗结果对家庭利用的作用时，我们使用了一个模型，其中包括以下特征：治疗样本（例如人口统计学和问题特征），家庭环境（例如家庭压力源和家庭组成）和治疗（例如，治疗结果和再入院）与家庭成员利用的关系。我们将使用线性和非线性混合模型来研究成本和利用率差异。这些模型适当地处理重复的度量和家庭内相关性，同时调整重要的混杂因素。我们在很长一段时间内我们的大量样本和丰富的详细自我报告和自动数据将使我们能够回答重要的流行病学和健康政策问题，这些问题有关使家庭成员有酒精和毒品问题的影响，家庭的医疗需求，成员，以及对这些问题治疗的家庭成员的影响。