Humphreys K, Moos R H
Program Evaluation and Resource Center, Department of Veterans Affairs Palo Alto Health Care System, Menlo Park, California 94025, USA.
Psychiatr Serv. 1996 Jul;47(7):709-13. doi: 10.1176/ps.47.7.709.
This study examined differences in outcomes, alcoholism treatment utilization, and costs between alcoholic individuals with no previous treatment history who chose to attend Alcoholics Anonymous (AA) or to seek help from a professional outpatient alcoholism treatment provider.
Participants in this three-year prospective study were recruited at alcoholism information and referral services and at detoxification units in the San Francisco Bay Area. Chi square and t tests and repeated-measures analyses of variance were used to examine data gathered from interviews with 201 participants at baseline and at one and three years.
At baseline, participants who chose to attend AA meetings (N = 135) were not significantly different from those who chose professional outpatient treatment (N = 66) in sex, marital status, employment, race, and symptoms of alcohol dependence and depression. However, AA attendees had lower incomes and less education and experienced more adverse consequences of drinking at baseline than did those who sought outpatient care, suggesting somewhat worse prognoses for the AA group. Over the three-year study, per-person treatment costs for the AA group were 45 percent (or $1,826) lower than costs for the outpatient treatment group. Despite the lower costs, outcomes for the AA group at both one and three years were similar to those of the outpatient treatment group.
Voluntary AA participation may significantly reduce professional treatment costs. Clinicians, researchers, and policymakers should recognize the potential health care cost offsets offered by AA and other self-help organizations.
本研究考察了既往无治疗史的酗酒者中,选择参加匿名戒酒互助会(AA)或寻求专业门诊酒精成瘾治疗服务的人群在治疗结果、酒精成瘾治疗利用情况及成本方面的差异。
这项为期三年的前瞻性研究的参与者,是在旧金山湾区的酒精成瘾信息与转诊服务机构以及戒毒所招募的。使用卡方检验、t检验和重复测量方差分析来检验从201名参与者在基线期、1年和3年时的访谈中收集的数据。
在基线期,选择参加AA会议的参与者(N = 135)与选择专业门诊治疗的参与者(N = 66)在性别、婚姻状况、就业情况、种族以及酒精依赖和抑郁症状方面没有显著差异。然而,与寻求门诊治疗的人相比,参加AA会议的人收入较低、受教育程度较低,且在基线期饮酒带来的不良后果更多,这表明AA组的预后可能稍差。在为期三年的研究中,AA组的人均治疗成本比门诊治疗组低45%(即1826美元)。尽管成本较低,但AA组在1年和3年时的治疗结果与门诊治疗组相似。
自愿参加AA可能会显著降低专业治疗成本。临床医生、研究人员和政策制定者应认识到AA和其他自助组织在医疗保健成本方面可能带来的抵消作用。