PubMed Health⌕ Search

Biomedical subjects

J O Blose

Publications and source records attributed to J O Blose.

13 recordsLinked to original sources

The reduction of health care costs associated with alcoholism treatment: a 14-year longitudinal study.

This study utilized two separate research designs to examine whether the initiation of alcoholism treatment is associated with a change in overall medical care cost in a population of alcoholics enrolled under a health plan sponsored by a large midwestern manufacturing corporation. In the longest longitudinal study of alcoholism treatment costs to date, a review of claims filed from 1974 to 1987 identified 3,729 alcoholics (3,068 of whom received treatment and 661 of whom did not). In one design, a time-series analysis found that following treatment initiation the total health care costs of treated alcoholics--including the cost of alcoholism treatment--declined by 23% to 55% from their highest pretreatment levels. Costs for identified but untreated alcoholics rose following identification. In a second design, analysis of variance was used to control for group differences including pretreatment health status and age. This analysis indicated that the posttreatment costs of treated alcoholics were 24% lower than comparable costs for untreated alcoholics. The study provides considerable evidence that alcoholism treatment can reduce overall medical costs in a heterogeneous alcoholic population (white collar/blue collar; fee-for-service/HMO).

Alcoholism↗

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.

Adult↗

Typical patterns and cost of alcoholism treatment across a variety of populations and providers.

This paper presents data on the utilization of alcoholism treatment services in three populations of insurance enrollees: enrollees covered by the insurance plan of a large midwestern manufacturing firm, 1981-1987 (N = 1.425); enrollees of the California Health Insurance Plan of the Public Employees Retirement System, 1974-1976 (N = 766); U.S. government civilian employees enrolled with the Aetna Insurance Company, 1980-1983 (N = 1,697). The average age of the treated alcoholics in these three groups ranged from 37 to 51. Between two-thirds and three-quarters were male. Inpatient alcoholism treatment services were more frequently used than outpatient, with inpatient admissions averaging between 1.2 and 1.5 per person. For enrollees of the midwestern manufacturing firm, total alcoholism treatment costs averaged $4,665 per person (December 1985 dollars). The influence of insurance plan coverage and other factors on utilization patterns is discussed.

Adult↗

Injury-related medical care utilization in a problem drinking population.

BACKGROUND: Population-based data on the overall risk of injury among problem drinkers are extremely limited. METHODS: We conducted an eight-year study of injury-related medical care utilization for a group of problem drinkers (n = 3 729) enrolled in the health insurance plan of a large manufacturing firm with plants in a number of midwestern states. A comparison non-problem drinking cohort matched on age, gender, and number of years of enrollment with the same company plan was also utilized. RESULTS: Problem drinkers utilized injury-related medical care at a rate 1.6 times that of the comparison group and experienced injury-related medical care costs which were three times as high. Increased risks were found for both men and women and for all ages studied. CONCLUSIONS: This study is one of the few to examine the overall incidence of fatal and non-fatal injuries among a large population of problem drinkers and provides evidence that higher medical care costs are associated with chronic alcohol use.

Adult↗

A comparison of occupational and nonoccupational disability payments and work absences for alcoholics and nonalcoholics.

We examined whether employed alcoholics have more frequent work absences and higher rates of disability benefit payments than do nonalcoholic employees. Using data from a large Midwestern manufacturing firm for the years 1974 through 1987, we studied two groups: 1828 hourly employees who had received an International Classification of Diseases-9 diagnosis indicating chronic alcohol abuse and a group of employees with no history of alcohol problems, matched on age, gender, length of enrollment, and retirement status. The alcoholic group had average overall indemnity payments about twice that of the nonalcoholic group ($1272 per year per capita v $671). Nonoccupational indemnity payments and work absences were also much higher for alcoholics. However, no statistically significant difference between the groups was found for occupational-related disability.

Absenteeism↗

Changes in health care costs and utilization associated with mental health treatment.

Health insurance claims of families covered by Aetna's Federal Employees Health Benefit Program from 1980 through 1983 were analyzed to determine if any changes in total health care utilization and costs were associated with the initiation of mental health treatment. A total of 26,915 families in which at least one member received mental health treatment were compared with a randomly selected group of 16,468 families in which no member had received mental health treatment. Total health care costs for those receiving mental health treatment were significantly higher than costs for the comparison group. However, those costs dropped significantly after initiation of mental health treatment and continued to decline over the study period. The biggest declines occurred among persons age 45 and older, a finding that may have important policy considerations.

Community Mental Health Services↗

Reduction of community alcohol problems: computer simulation experiments in three counties.

A series of alcohol abuse prevention strategies was evaluated using computer simulation for three counties in the United States: Wake County, North Carolina, Washington County, Vermont and Alameda County, California. A system dynamics model composed of a network of interacting variables was developed for the pattern of alcoholic beverage consumption in a community. The relationship of community drinking patterns to various stimulus factors was specified in the model based on available empirical research. Stimulus factors included disposable income, alcoholic beverage prices, advertising exposure, minimum drinking age and changes in cultural norms. After a generic model was developed and validated on the national level, a computer-based system dynamics model was developed for each county, and a series of experiments was conducted to project the potential impact of specific prevention strategies. The project concluded that prevention efforts can both lower current levels of alcohol abuse and reduce projected increases in alcohol-related problems. Without such efforts, already high levels of alcohol-related family disruptions in the three counties could be expected to rise an additional 6% and drinking-related work problems 1-5%, over the next 10 years after controlling for population growth. Of the strategies tested, indexing the price of alcoholic beverages to the consumer price index in conjunction with the implementation of a community educational program with well-defined target audiences has the best potential for significant problem reduction in all three counties.

Adolescent↗

Public availability of distilled spirits: structural and reported consumption changes associated with liquor-by-the-drink.

The impact of the implementation of liquor-by-the-drink (LBD) in North Carolina on the availability of distilled spirits and on individual drinking behavior is evaluated. Distilled spirits outlet data show that the shift from brown-bagging to LBD resulted in a 250% increase in the number of places where liquor could be purchased, whereas the number of on-premise establishments where liquor could be consumed remained relatively constant. Most drinkers in both LBD and non-LBD counties purchase mixed beverages at least occasionally, and such consumption occurs only slightly less frequently than on-premise beer and wine consumption.

Alcohol Drinking↗

Liquor-by-the-drink and alcohol-related traffic crashes: a natural experiment using time-series analysis.

A quasi-experimental study was conducted to estimate the impact of liquor-by-the-drink (LBD) on alcohol-related traffic accidents in North Carolina counties. Time-series analysis for the period from January 1973 through December 1982 found LBD was associated with statistically significant increases of 16 to 24% in both the number of police-reported alcohol-related accidents and in single vehicle nighttime accidents among male drivers 21 years of age and older in counties implementing LBD. No change in alcohol-related accidents was found for non-LBD counties. Single vehicle nighttime accidents involving male drivers under 21 did not change for either the experimental or comparison groups.

Accidents, Traffic↗

Alcoholism treatment and total health care utilization and costs. A four-year longitudinal analysis of federal employees.

This study examines the effect of alcoholism treatment services on overall health care utilization and costs for health insurance enrollees under the Federal Employees Health Benefit Program with Aetna Insurance Company, 1980 through 1983. Claims filed by 1697 treated alcoholics (and their family members) continuously enrolled with Aetna during the study period were examined. In the years prior to initial alcoholism treatment, alcoholics incurred gradually increasing total health care costs on the average. These costs rose dramatically in the six months prior to treatment, began to decline after treatment initiation, and continued to fall during several follow-up years. For alcoholics less than 45 years of age, costs eventually declined to a point comparable with the lowest pretreatment levels.

Adult↗

Impact of changes in distilled spirits availability on alcohol distribution.

An important change in the distribution and availability of distilled spirits in North Carolina has resulted from a move to liquor-by-the-drink. Previously drinkers had to plan to bring distilled spirits with them to eating establishments and purchase mixers and ice; LBD eliminates the need for such planning and makes liquor more easily available. The shift from more restrictive to less restrictive availability does not occur immediately after a local election but is gradual over a two-year period following a local election.

Alcoholic Beverages↗