Suchergebnisse

For much of 2009 and early 2010, discussions of health care policies dominated national discourse in the United States. The prolonged and often acrimonious debates brought into sharp focus the enormous, complex, and highly fragmented system that provides health care in the United States. Considerable attention was also devoted to demonstrating the advanced state of this country's medical knowledge, technology, and health services.

This study investigates whether alcoholism treatment costs are offset by reductions in other medical treatment costs by comparing people treated for alcoholism with a matched comparison group. The alcoholism treatment group is defined by diagnoses of alcohol dependence, abuse, or psychoses from health insurance claims filed between January 1980 and June 1987. A comparison sample was matched on age, gender, and insurance coverage. In this primarily methodological study, expected costs for nonalcoholism treatments were calculated from standardized regressions. Offset effects were measured from the insurer's perspective through differences in expected total nonalcoholism treatment costs in the periods preceding and following alcoholism treatment. Members of the alcoholism treatment group were more likely than the comparison group to be hospitalized and to need other (nonalcoholism) medical treatment, thus incurring higher total costs. Offset effects emerged for patients with alcohol abuse and without mental psychosis comorbidities.

This study examines the efficient provision of alcoholism treatment by determining how several factors predict long-term alcoholism treatment costs. Treatment costs are estimated with an integrated analysis of insurance claims data that considers the decision to seek alcoholism treatment, the treatment location (inpatient or outpatient), and treatment costs conditional on treatment location. The analysis is useful for determining whether increased or alternative treatments in the short term influence treatment costs in the long term. We find that the probability of long-term treatment depends on whether the diagnosis is for alcohol abuse or alcohol dependence, and whether a comorbidity is present. Comorbidities have an impact on long-term costs by affecting where treatment occurs. Increased short-term treatment has a small negative effect on long-term costs for patients with dependence, and a negligible effect on abusers. Most of the treatment costs, however, occur in the short term.