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酒精中毒治疗对医疗总费用的影响:一项为期六年的研究。

Impact of alcoholism treatment on total health care costs: a six-year study.

作者信息

Holder H D, Hallan J B

出版信息

Adv Alcohol Subst Abuse. 1986 Fall;6(1):1-15. doi: 10.1300/J251v06n01_01.

Abstract

This is a six-year longitudinal study to determine if the treatment of alcoholism as a primary diagnosis results in a reduction of total health care cost and/or utilization for the alcoholic as well as other nonalcoholic family members. All health care costs and utilization were tracked for a group of 90 families, representing 245 individuals, enrolled with Blue Cross/Blue Shield through the Health Benefits Division, California Public Employees Retirement System. At least one member in each family received treatment under a specific diagnosis of alcoholism from July 1, 1974 to December 1, 1975. All health care utilization and costs were obtained for a 12-month period before initial treatment for alcoholism and up to July 1, 1979. In addition, a matched group of 83 comparison families with no alcoholic members and covering 291 persons was selected to reflect family composition, age, and sex. Total health care data were obtained over the same time period for these families. The results indicated that utilization and costs of all forms of inpatient care for both nonalcoholic family members as well as alcoholic family members dropped after alcoholism treatment began and ultimately reached a level similar to the matched comparison group. On the average, outpatient care also decreased in terms of frequency and costs for all members of the alcoholic's family; and in similar fashion converged in the fourth follow-up period to the matched comparison families. Total health care costs per family member decreased substantially over time following initiation of treatment of the alcoholic family member. The findings support the contention that the direct treatment of alcoholism can yield significant reductions in total health care costs and utilization not only for the alcoholic but his/her family members as well.

摘要

这是一项为期六年的纵向研究,旨在确定将酒精中毒作为主要诊断进行治疗是否会降低酗酒者以及其他非酗酒家庭成员的总体医疗保健成本和/或利用率。对通过加利福尼亚公共雇员退休系统健康福利部门加入蓝十字/蓝盾的90个家庭(代表245个人)的所有医疗保健成本和利用率进行了跟踪。从1974年7月1日至1975年12月1日,每个家庭中至少有一名成员接受了酒精中毒的特定诊断治疗。获取了酗酒者初始治疗前12个月期间以及截至1979年7月1日的所有医疗保健利用率和成本。此外,选择了一组83个无酗酒成员的对照家庭(涵盖291人),以反映家庭构成、年龄和性别。在同一时期获取了这些家庭的总体医疗保健数据。结果表明,酗酒治疗开始后,非酗酒家庭成员和酗酒家庭成员的所有形式住院护理的利用率和成本均下降,并最终达到与匹配对照组相似的水平。平均而言,酗酒者家庭所有成员的门诊护理在频率和成本方面也有所下降;并以类似方式在第四次随访期与匹配对照家庭趋于一致。在对酗酒家庭成员开始治疗后,每个家庭成员的总体医疗保健成本随着时间的推移大幅下降。这些发现支持了这样的论点,即直接治疗酒精中毒不仅可以使酗酒者,而且其家庭成员的总体医疗保健成本和利用率大幅降低。

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