Integrated outpatients treatment for medically ill alcoholic men: results from a quasi-experimental study.
OBJECTIVE
This report documents the findings of a quasi-experimental study of a new approach to treating medically ill alcoholics. The intervention, the Alcohol Related Disorders (ARD) Clinic, consists of concurrent alcohol treatment and medical care delivered by an interdisciplinary team in an outpatient medical clinic at the Minneapolis Veterans Affairs Medical Center (MVAMC).


METHODS
We compared 50 ARD patients with 50 patients who met eligibility for the clinic, but had to be referred elsewhere because the clinic was full at the time (referred patients). Referred patients received medical care in other MVAMC clinics or in the community.


RESULTS
During the 2-year follow-up period, ARD patients returned for outpatient visits over three times as often as referred patients (p < .001). More referred patients received no follow-up care at MVAMC (p < .01). ARD patients had more frequent (p < .05) but briefer (p < .01) hospitalizations. Almost twice as many referred (32%) as ARD patients (18%) died during the follow-up period. Referred patients ranged from 1.18 times less likely to 5.03 times more likely to die during follow-up than those in the ARD group (p = .11). ARD patients lived for an average of 82 days longer than referred patients, and each ARD clinic visit in the second follow-up year predicted an additional 3.5 days lived (p < .01).


CONCLUSIONS
Integrated outpatient treatment for medically ill alcoholics appears to improve outpatients follow-up and alter patterns of hospitalization when compared with standard approaches. Two-year mortality may have been reduced as a result.
Willenbring
M L
ML
Addictive Disorders Section, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA.
Olson
D H
DH
Bielinski
J
J
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000401:mortality / Q000534:rehabilitation*; D000553:Ambulatory Care; D003131:Combined Modality Therapy; D015897:Comorbidity; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008108:Liver Diseases, Alcoholic / Q000401:mortality / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D010348:Patient Care Team; D010359:Patient Readmission / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014728:Veterans