title: Utilization of services for mentally ill chemically abusing patients discharged from residential treatment.
abstract: Little is known about outcomes of treatment for individuals with mental illness and chemical dependencies. This article compares services utilization preadmission and postdischarge in 534 patients discharged from a residential treatment program in Washington State. A number of services, including chemical dependency detoxification, mental health crisis, inpatient psychiatric, medical emergency, and general medical inpatient hospitalization, were used less frequently in the period after discharge. The total reimbursement for all Medicaid services decreased by 44% from $5 million in the year prior to discharge to $2.8 million in the year after discharge. Also, individuals (32%) who completed the program were less likely to use costly, acute care services. This study was limited by the absence of a control group and posttreatment alcohol and drug use data. In addition, other unmeasured factors could have explained the association between program completion and better outcomes.
authors.affiliation: Department of Medicine, University of Washington, Seattle 98105, USA. cmaynard@u.washington.edu
authors.forename: C
authors.initials: C
authors.lastname: Maynard
authors.forename: G B
authors.initials: GB
authors.lastname: Cox
authors.forename: A
authors.initials: A
authors.lastname: Krupski
authors.forename: K
authors.initials: K
authors.lastname: Stark
mesh_terms: D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data*; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008498:Medical Record Linkage; D012044:Regression Analysis; D012114:Residential Treatment; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States; D014861:Washington / Q000453:epidemiology