title: Treatment for substance use disorders in a privately insured population under managed care: costs and services use.
abstract: The study investigated the relationship of substance use disorders, concurrent psychiatric disorders, and patient demographics to patterns of treatment use and spending in behavioral health and medical treatment sectors. We examined claims data for individuals covered by the same organization. Services spending and use were examined for 1899 individuals who received substance use disorder treatment in 1997. Medical and pharmacy spending was assessed for 590 individuals (31.1%). The most prevalent services were outpatient, intensive outpatient, residential, and detoxification. Average mental health/substance abuse (MHSA) care spending conditional on use was highest for those with concurrent alcohol and drug disorders (US 5235 dollars) compared to those with alcohol (US 2507 dollars) or drugs (US 3360 dollars) alone; other psychiatric illness (US 4463 dollars) compared to those without (US 1837 dollars); and employees' dependents (US 4138 dollars) compared to employees (US 2875 dollars) or their spouses (US 2744 dollars). A significant minority also sought MHSA services in the medical sector. Understanding services use and associated costs can best be achieved by examining services use across treatment sectors.
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA. Shelly_greenfield@hms.harvard.edu
authors.forename: Shelly F
authors.initials: SF
authors.lastname: Greenfield
authors.forename: Vanessa
authors.initials: V
authors.lastname: Azzone
authors.forename: Haiden
authors.initials: H
authors.lastname: Huskamp
authors.forename: Brian
authors.initials: B
authors.lastname: Cuffel
authors.forename: Thomas
authors.initials: T
authors.lastname: Croghan
authors.forename: William
authors.initials: W
authors.lastname: Goldman
authors.forename: Richard G
authors.initials: RG
authors.lastname: Frank
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003365:Costs and Cost Analysis / Q000191:economics*; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D008605:Mental Health Services / Q000191:economics; D008875:Middle Aged; D017149:Private Sector / Q000191:economics; D019966:Substance-Related Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology