The utilization of medical care by treated alcoholics: longitudinal patterns by age, gender, and type of care.

This study examines how the impact of alcoholism treatment on overall health care cost is related to age, gender, and maturation (aging). Variations in the type of health care used also are examined. Data were obtained on treated alcoholics (both employees and dependents) who were health insurance enrollees of a large midwestern manufacturing corporation during the years 1974-1987. Treated alcoholics with a minimum of 6 years of continuous insurance coverage (N = 2,259) were included in the analysis. No treatment-related differences in overall health care cost were found between men and women. Significant differences were found by age: On the average, individuals in the 30 and under and the 31-50 age groups experienced declines in health care costs following initiation of treatment, whereas those over 50 experienced increasing costs. When compared to a group of nonalcoholics of the same age and gender, alcoholics had significantly higher costs on the average. Both groups showed gradually increasing costs during a 10-year pretreatment period, demonstrating the effect of aging on long-term health care costs. The gap between the two groups narrowed following treatment, suggesting the convergence of the alcoholics to their age and gender cohort baseline may potentially occur over time.