医疗补助的照护管理：高费用成瘾治疗客户的描述。
Medicaid care management: description of high-cost addictions treatment clients.
机构信息
Health and Treatment Research and Analysis Division, The National Center on Addiction and Substance Abuse at Columbia University, 633 Third Avenue, New York, NY 10017, USA.
出版信息
J Subst Abuse Treat. 2013 Sep;45(3):280-6. doi: 10.1016/j.jsat.2013.02.009. Epub 2013 Apr 8.
Abstract
High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals <90th percentile of AODTx expenditures (n=41,054); high-cost clients in the top decile of AODTx expenditures (HC; n=5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals.
摘要
高利用率的酒精和其他药物治疗（AODTx）服务是医疗保健成本控制的重点。我们研究了医疗补助计划资助的 AODTx 客户的特征，将他们分为三组进行比较：AODTx 支出低于第 90 百分位的个人（n=41054）；AODTx 支出最高十分之一的高成本客户（HC；n=5718）；以及在纽约州 22 个县实施的针对 HC 客户的慢性护理管理（CM）计划中的 1760 名参保人。将医疗补助计划和州 AODTx 登记数据库合并，以获取人口统计学、临床、社会需求和治疗史数据。医疗补助计划资助的 AODTx 费用中，HC 客户占 49%。正如预期的那样，HC 客户有重大的社会福利需求、合并的医疗和精神疾病状况，以及使用住院服务。CM 计划成功地招募了一些高需求、高成本的客户，但在接触最昂贵和最脱节的个人方面面临障碍。
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