2.50
Hdl Handle:
http://hdl.handle.net/10755/157964
Type:
Presentation
Title:
Substance Abuse Treatments in Three Managed Care Settings
Abstract:
Substance Abuse Treatments in Three Managed Care Settings
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:McNeese-Smith, Donna, RN, EdD, CNAA
P.I. Institution Name:University of California Los Angeles, School of Nursing
Title:Associate Professor
Contact Address:Box 956919, 700 Tiverton Avenue, Los Angeles, CA, 90095-6919, USA
Contact Telephone:951-769-3705
Substance abuse treatment (SAT) is beneficial and cost effective. Treatment outcomes are consistently positive related to duration (length) of treatment in studies prior to the advent of managed care (MC). However, under MC, treatment durations have become shorter, and variability in treatment duration reflects the complex interplay between MC controls, clinical assessment of client needs, and client self-selection. The purpose of this study was to describe and compare SAT processes provided in three treatment settings under MC with respect to location, mode, intensity, and duration of treatment, and examine these variables in relation to client outcomes (treatment completion, drug use, quality of life and cost). Methods: This study recruited 170 clients using stratified random sampling to increase the representation of women and ethnic minorities. Clients were interviewed prior to treatment and at the completion of treatment using multiple valid and reliable instruments including a score for drug use frequency and intensity (DATAR). Sample: Of the 170 clients recruited, all were insured under MC, 80% completed treatment, 45.3% were female, 65% Caucasian, 20% Hispanic, 8% African-American, and 5% Asian or Filipino. Seventy-five percent had some college education, and 57% were employed full time. Drugs most seriously abused were, alcohol (47%), methamphetamine (19%), marijuana (8%), cocaine (7%), and crack (6%). Results: The mean DATAR score improved from before treatment to completion of treatment (3.9 versus .61) (drug severity index ranging from 0 to 8; higher indicates greater severity). Intensity of Treatment was positively related to total hours of treatment, treatment completion, days of sobriety after treatment, DATAR Score before treatment, and negatively related to substance use during treatment (lapses) and treatment duration. Duration of SAT was positively related to lapses, treatment completion, and negatively related to total hours of therapy, intensity, and DATAR Score before treatment. Substance use during SAT (lapse) was positively related to duration and the DATAR score after treatment, and negatively related to total hours of treatment, intensity, and quality of life after treatment. Days of sobriety 30 days after treatment was positively related to intensity of treatment, total hours of treatment, treatment completion, quality of life after treatment, and negatively related to the DATAR score after treatment. Total Quality of Life mean score (range 1 to 5; higher is better) before treatment was 3.01; while after treatment was 4.11. Days of sobriety increased after treatment, though females and ethnic minorities improved more than Caucasian males. However, females showed increased relapses during treatment compared to males (1.33 versus .72). Cost Analysis: Costs for the Outpatient Program (OP) were $39.05/hour of therapy ($1862.74 average course of treatment) whereas, costs for the residential day, and OP combined were $29.57/hour of therapy, or $252.40/day of residential care ($5,574.35 average course of treatment). Conclusions: Positive outcomes of treatment under MC are related to intensity of treatment while duration is related to increased relapse and increased drug use after treatment. Females and ethnic minorities did as well or better than Caucasian males. Future studies would benefit from the use of longitudinal designs.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSubstance Abuse Treatments in Three Managed Care Settingsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157964-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Substance Abuse Treatments in Three Managed Care Settings</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">McNeese-Smith, Donna, RN, EdD, CNAA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California Los Angeles, School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Box 956919, 700 Tiverton Avenue, Los Angeles, CA, 90095-6919, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">951-769-3705</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dmcneese@sonnet.ucla.edu</td></tr><tr><td colspan="2" class="item-abstract">Substance abuse treatment (SAT) is beneficial and cost effective. Treatment outcomes are consistently positive related to duration (length) of treatment in studies prior to the advent of managed care (MC). However, under MC, treatment durations have become shorter, and variability in treatment duration reflects the complex interplay between MC controls, clinical assessment of client needs, and client self-selection. The purpose of this study was to describe and compare SAT processes provided in three treatment settings under MC with respect to location, mode, intensity, and duration of treatment, and examine these variables in relation to client outcomes (treatment completion, drug use, quality of life and cost). Methods: This study recruited 170 clients using stratified random sampling to increase the representation of women and ethnic minorities. Clients were interviewed prior to treatment and at the completion of treatment using multiple valid and reliable instruments including a score for drug use frequency and intensity (DATAR). Sample: Of the 170 clients recruited, all were insured under MC, 80% completed treatment, 45.3% were female, 65% Caucasian, 20% Hispanic, 8% African-American, and 5% Asian or Filipino. Seventy-five percent had some college education, and 57% were employed full time. Drugs most seriously abused were, alcohol (47%), methamphetamine (19%), marijuana (8%), cocaine (7%), and crack (6%). Results: The mean DATAR score improved from before treatment to completion of treatment (3.9 versus .61) (drug severity index ranging from 0 to 8; higher indicates greater severity). Intensity of Treatment was positively related to total hours of treatment, treatment completion, days of sobriety after treatment, DATAR Score before treatment, and negatively related to substance use during treatment (lapses) and treatment duration. Duration of SAT was positively related to lapses, treatment completion, and negatively related to total hours of therapy, intensity, and DATAR Score before treatment. Substance use during SAT (lapse) was positively related to duration and the DATAR score after treatment, and negatively related to total hours of treatment, intensity, and quality of life after treatment. Days of sobriety 30 days after treatment was positively related to intensity of treatment, total hours of treatment, treatment completion, quality of life after treatment, and negatively related to the DATAR score after treatment. Total Quality of Life mean score (range 1 to 5; higher is better) before treatment was 3.01; while after treatment was 4.11. Days of sobriety increased after treatment, though females and ethnic minorities improved more than Caucasian males. However, females showed increased relapses during treatment compared to males (1.33 versus .72). Cost Analysis: Costs for the Outpatient Program (OP) were $39.05/hour of therapy ($1862.74 average course of treatment) whereas, costs for the residential day, and OP combined were $29.57/hour of therapy, or $252.40/day of residential care ($5,574.35 average course of treatment). Conclusions: Positive outcomes of treatment under MC are related to intensity of treatment while duration is related to increased relapse and increased drug use after treatment. Females and ethnic minorities did as well or better than Caucasian males. Future studies would benefit from the use of longitudinal designs.</td></tr></table>en_GB
dc.date.available2011-10-26T20:22:33Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:22:33Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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