William Fals-Stewart, PhD¹, Brian T. Yates, PhD², and Keith C. Klostermann, PhD¹. (1) Research Institute on Addictions, State University of New York, University at Buffalo, 1021 Main Street, Buffalo, NY 14203-1016, (2) Dept. of Psychology, American University, 4400 Mass. Ave., N.W., American University, Washington, DC 20016-8062, 301-775-1892, briantyates@earthlink.net

Although many studies have evaluated the clinical effectiveness of different treatments for substance abuse, far fewer have examined their benefits. More specifically, those investigations that have been conducted examining the cost-benefits of different treatments for substance abuse have concluded that participation in substance abuse treatment results in posttreatment cost utilization reductions across multiple dimensions (e.g., legal entanglements, inpatient and outpatient substance abuse treatment services). However, patients vary considerably in their service utilization after their participation in treatment has ceased. This heterogeneity may represent variation around a common trajectory of utilization or may reflect different cost utilization patterns for subgroups of patients. The purpose of the present investigation was to explore cost utilization for patients (N = 291) who participated in substance abuse treatment and identify patient subgroup patterns. Cost utilization was evaluated quarterly for legal involvement (e.g., arrests, time in jail) and mental health, substance abuse services during the 12 months after patients were discharged from treatment. Generalized Growth Mixture Modeling revealed four trajectory classes of patients: (a) High Utilization, (b) Low Utilization; (c) Stable Utilization; and (d) Rising Utilization. Multinominal logistic regression revealed patients who were in the High Utilization group, compared to the other classes, used drugs more frequently during treatment, had shorter treatment tenures (due to premature dropout), and had greater legal problems at program admission. Patients in the Low Utilization group were more likely to remain abstinent during the year after treatment and lower addiction severity when admitted to the programs.

Learning Objectives:

• Evaluate the cost utilization for patients who participated in substance abuse treatment and identify patient subgroup patterns.
• Describe a model (Generalized Growth Mixture Modeling) that can be used to analyze the variance in service utilization patterns of patients who participated in substance abuse treatment.
• Identify four trajectories of service utilization for patients after treatment and their implications for future services.
• Discuss cost utilization and its implications on the delivery of services.
• Recognize the variance in cost-benefits among patients, as well as the importance of incorporating cost-benefit data into future program evaluations."

Keywords: Cost Issues,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.