This proposal responds to the National Institute on Drug Abuse's Program Announcement, PA-95-027, of February 3, 1995, on the linkage of drug abuse treatment and medical care. Although the prevalence of medical problems among substance abuse patients is known to be extensive, a question remains of what is the cost and effectiveness, both in terms of substance abuse and medical outcomes, of providing primary medical care in the context of structured outpatient drug abuse treatment. Specifically, this proposal describes a controlled, random assignment comparison of two treatment conditions among 650 substance dependent patients (34% women, 13% African American, and 10% Hispanic) treated in the substance abuse program of a large health maintenance organization (HMO). The two conditions are 1) """"""""integrated"""""""" services, where patients receive all their primary health care from medical personnel within the substance abuse unit itself; and 2) an """"""""independent,"""""""" treatment as usual group, where patients receive their primary health care and drug abuse treatment services independently at different sites; these substance abuse patients receive their primary health care through the regular HMO clinics. The study compares the effects of these two models of service delivery during the course of drug abuse treatment, measuring treatment engagement, length of stay, and drug use. It also compares post treatment outcome and improvement rates in the areas of substance use, medical status, levels of psychosocial functioning, and medical care utilization between the two conditions, and it attempts to specify patient characteristics associated with successful treatment outcomes. Finally, it compares the costs of the Integrated and Independent (treatment as usual) conditions, and assesses cost effectiveness of the two sets of service arrangements. The HMO setting is an important """"""""real world"""""""" environment in which to conduct such a study; it has a heterogeneous patient population, and such managed care settings are increasingly becoming a predominant form of service delivery.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA010572-03
Application #
2749153
Study Section
Special Emphasis Panel (SRCD (55))
Program Officer
Flanzer, Jerry
Project Start
1996-09-20
Project End
2000-07-31
Budget Start
1998-08-01
Budget End
1999-07-31
Support Year
3
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Kaiser Foundation Research Institute
Department
Type
DUNS #
City
Oakland
State
CA
Country
United States
Zip Code
94612
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Weisner, Constance; Ray, G Thomas; Mertens, Jennifer R et al. (2003) Short-term alcohol and drug treatment outcomes predict long-term outcome. Drug Alcohol Depend 71:281-94
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Parthasarathy, Sujaya; Mertens, Jennifer; Moore, Charles et al. (2003) Utilization and cost impact of integrating substance abuse treatment and primary care. Med Care 41:357-67
Kohn, Carolynn S; Tsoh, Janice Y; Weisner, Constance M (2003) Changes in smoking status among substance abusers: baseline characteristics and abstinence from alcohol and drugs at 12-month follow-up. Drug Alcohol Depend 69:61-71
Kohn, Carolynn S; Mertens, Jennifer R; Weisner, Constance M (2002) Coping among individuals seeking private chemical dependence treatment: gender differences and impact on length of stay in treatment. Alcohol Clin Exp Res 26:1228-33
Walter, Lawrence J; Parthasarathy, Sujaya; Allen, Steven et al. (2002) Medicaid patients in a private health maintenance organization: patterns of chemical dependency treatment. J Behav Health Serv Res 29:1-14

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