title: Comparison of outcomes by gender and for fee-for-service versus managed care: a study of nine community programs.
abstract: During-treatment services and 7-month posttreatment entry outcome of cocaine- or alcohol-dependent men (n = 145) and women (n = 149) Target City patients receiving either standard fee-for-services (n = 183) or managed care treatment funding (n = 111) in nine community outpatient programs were compared. No differences were found in treatment services received by the various subgroups. Regression analyses compared the four described subgroups (Gender x Type of Funding) on their seven Addiction Severity Index composite scores at 7 months postadmission controlling for the respective baseline composite score and several background variables on which the groups differed. Surprisingly few outcome differences were revealed between men and women patients and patients receiving the two forms of treatment funding. The only difference noted was that patients treated via managed care showed more improvement in the drug area. The need for further evaluation of the effects of managed care is emphasized.
authors.affiliation: The PENN-VA Center for Studies of Addiction and the Treatment Research Institute, University of Pennsylvania School of Medicine, 3900 Chestnut Street, 19104, Philadelphia, PA, USA. Alterman@Research.trc.upenn.edu
authors.forename: A I
authors.initials: AI
authors.lastname: Alterman
authors.forename: M
authors.initials: M
authors.lastname: Randall
authors.forename: A T
authors.initials: AT
authors.lastname: McLellan
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000628:therapy*; D018588:Fee-for-Service Plans; D005260:Female; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012737:Sex Factors; D016896:Treatment Outcome