12-Step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment.
BACKGROUND
Adolescents who attend 12-step groups following alcohol and other drug (AOD) treatment are more likely to remain abstinent and to avoid relapse post-treatment. We examined whether 12-step attendance is also associated with a corresponding reduction in health care use and costs.


METHODS
We used difference-in-difference analysis to compare changes in seven-year follow-up health care use and costs by changes in 12-step participation. Four Kaiser Permanente Northern California AOD treatment programs enrolled 403 adolescents, 13-18-years old, into a longitudinal cohort study upon AOD treatment entry. Participants self-reported 12-step meeting attendance at six-month, one-year, three-year, and five-year follow-up. Outcomes included counts of hospital inpatient days, emergency room (ER) visits, primary care visits, psychiatric visits, AOD treatment costs and total medical care costs.


RESULTS
Each additional 12-step meeting attended was associated with an incremental medical cost reduction of 4.7% during seven-year follow-up. The medical cost offset was largely due to reductions in hospital inpatient days, psychiatric visits, and AOD treatment costs. We estimate total medical use cost savings at $145 per year (in 2010 U.S. dollars) per additional 12-step meeting attended.


CONCLUSIONS
The findings suggest that 12-step participation conveys medical cost offsets for youth who undergo AOD treatment. Reduced costs may be related to improved AOD outcomes due to 12-step participation, improved general health due to changes in social network following 12-step participation, or better compliance to both AOD treatment and 12-step meetings.
Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison 53715, USA. marlon.mundt@fammed.wisc.edu
Marlon P
MP
Mundt
Sujaya
S
Parthasarathy
Felicia W
FW
Chi
Stacy
S
Sterling
Cynthia I
CI
Campbell
D000293:Adolescent; D000437:Alcoholism / Q000191:economics* / Q000523:psychology / Q000534:rehabilitation*; D001249:Asthma / Q000150:complications / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000523:psychology; D003627:Data Interpretation, Statistical; D003710:Demography; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008297:Male; D008603:Mental Health; D012657:Self-Help Groups / Q000191:economics*; D012907:Smoking; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000191:economics* / Q000523:psychology / Q000534:rehabilitation*