title: Recent trends in the financing of substance abuse treatment: implications for the future.
abstract: OBJECTIVE
  This article focuses on the implications of a recent study of substance abuse (SA) and mental health treatment expenditures for substance abuse treatment policy. Public and private expenditures for SA treatment are estimated and compared with those for mental health and all health care in the period between 1987 and 1997.
  
  
  METHODS
  Estimates of SA treatment expenditures were segregated from the Health Care Financing Administration's National Health Accounts across the ten-year period. Information about use, charges, and payments by provider type, payer, and diagnosis was obtained from numerous nationally representative data sets and large claims databases. Those data were used to estimate SA treatment expenditures in the general service sector. For the specialty sector two specialty facility surveys were used to estimate SA treatment expenditures. Information from the two sectors was combined and reconciled to the National Health Accounts. PRINCIPAL FINDINGS. A dramatic shift in SA expenditures away from private financing and toward public payers, as well as a shift away from hospital treatment settings, occurred between 1987 and 1997.
  
  
  CONCLUSIONS
  Evidence from this article and other research suggests that growth in SA expenditures has been contained relative to growth in all health spending. How savings from SA treatment are being invested and whether expenditure levels are appropriate to supply treatment of acceptable quality needs further study.
authors.forename: J
authors.initials: J
authors.lastname: Dilonardo
authors.forename: M
authors.initials: M
authors.lastname: Chalk
authors.forename: T L
authors.initials: TL
authors.lastname: Mark
authors.forename: R M
authors.initials: RM
authors.lastname: Coffey
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D005380:Financing, Government / Q000706:statistics & numerical data / Q000639:trends; D005382:Financing, Personal / Q000706:statistics & numerical data / Q000639:trends; D019538:Health Care Surveys; D005102:Health Expenditures / Q000145:classification / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007358:Insurance, Psychiatric / Q000706:statistics & numerical data / Q000639:trends; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D017149:Private Sector / Q000191:economics* / Q000706:statistics & numerical data; D017150:Public Sector / Q000191:economics* / Q000706:statistics & numerical data; D016320:Substance Abuse Treatment Centers / Q000191:economics / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D014481:United States / Q000453:epidemiology