Patterns of health services use associated with Veterans Affairs outpatient substance-use treatment.

Stecker T, Curran GM, Han X, Booth BM. Patterns of health services use associated with Veterans Affairs outpatient substance-use treatment. Journal of Studies On Alcohol. 2007 Jul 1; 68(4):510-8.

Related HSR&D Project(s)

• IIR 98-086 – Patterns of Health Services Use Associated with Substance Abuse Treatment

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Abstract:

OBJECTIVE: This study examined service use and costs associated with receiving intensive outpatient (IOP) substance-use treatment. METHOD: Veterans Affairs national databases were used to identify all veterans receiving IOP substance-use treatment in fiscal year (FY) 1999. Changes in the use of health services (2 years pretreatment compared with 2 years posttreatment) were examined. Three IOP treatment groups were defined: (1) veterans attending 1-5 IOP visits (n = 2,384), (2) 6-14 IOP visits (n = 2,940), and (3) > or = 15 IOP visits (n = 3,005). In addition, a demographically matched no-treatment group was defined as veterans in primary care with a substance-use diagnosis and no substance-use treatment in FY 1999 (n = 7,328). General medical, psychiatric, and substance-use encounters in inpatient and outpatient settings were retrieved for the 4 years. Generalized estimating equations analyses were used to compare changes in service use across the three IOP groups controlling for demographic characteristics and comorbidity. RESULTS: Total outpatient visits increased in all three treatment groups after IOP, with the largest increase observed in the group with > or = 15 visits (mean visits = 5, 44, and 57, respectively). In comparison, total visits decreased in the no-treatment group (-7). This pattern was similar across settings (general medical, psychiatric, and substance use). Total inpatient days decreased among the four groups, with the no-treatment group having the least amount of decrease (mean change in days = .34, .32, .18, and .03, respectively). Analysis of cost data showed similar findings. CONCLUSIONS: Results indicated that more intense IOP treatment is associated with increases in subsequent psychiatric, substance-use, medical, and total outpatient care and decreases in expensive inpatient care.