Cost effectiveness of alcoholism treatment in partial hospital versus inpatient settings after brief inpatient treatment: 12-month outcomes.
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Biomedical subjects
Publications and source records attributed to B McCrady.
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This report examines the correlates of early treatment termination by patients being treated for alcohol abuse or dependence. All of the study subjects were participants in a controlled experimental investigation of the differences in clinical outcome and treatment cost of extended inpatient and partial hospital treatment. A large number of clinical variables demonstrated no difference between groups, except for the greater likelihood of a DSM III Axis I diagnosis of alcohol abuse or dependence in the treatment completers. In contrast, three of four system variables differentiated completers from noncompleters. Patients treated by hospital-employed psychiatrists, in contrast to private psychiatrists, were more likely to complete the program; 4 sequential months in the middle phase of the study were associated with noncompletion of treatment; and patients who were detoxified on the preferentially designated unit were more likely to receive some specialized alcohol treatment. The authors interpret these data to indicate that treatment adherence is influenced by factors affecting the cohesiveness of the treatment delivery system. The failure of patient characteristic variables to predict treatment adherence may well be a result of their comparative insignificance in relation to system variables.
Six-month outcomes for alcohol misusers assigned to extended inpatient hospitalization and to partial hospitalization were comparable for alcohol consumption and social and vocational roles. However, the subjective well-being of partial hospital patients was greater and their treatment costs were lower.
The spouses of hospitalized alcoholics scored within the normal range on Lanyon's Psychological Screening Inventory; on two of three scales their scores were not significantly different from those of a normative sample.
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