The 130th Annual Meeting of APHA

3285.0: Monday, November 11, 2002 - Board 8

Abstract #39036

Effect of benefit design on the receipt of treatment following detoxification

Tami L. Mark, PhD1, Rosanna M. Coffey, PhD1, Mady Chalk, PhD2, and Joan D Dilonardo, PhD2. (1) Outcomes Research and Econometrics, The MEDSTAT Group, 4301 Connecticut Ave. NW, Suite 330, Washington, DC 20008, 202-719-7832,, (2) Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockwall II Building, Suite 740, 5515 Security Lane, Rockville, MD 20852

Objective: This study examined the determinants of whether someone received follow-up treatment 30 days after receiving inpatient substance abuse detoxification. Methods: Data came from 1997-1999 private employer claims. A benefit simulation model was developed to determine the amount a patient would have to pay out-of-pocket for one outpatient substance abuse visit following detoxification, using benefit information on insurance policies. Logistic regression analysis was used to predict factors associated with whether or not follow-up treatment was received within thirty days of hospital discharge. Variables controlled in the model of treatment included: plan type (HMO, POS, PPO, or FFS), out-of-pocket payments, the presence of a behavioral carve-out plan, whether they received rehabilitation treatment while an inpatient, age, age-squared, gender, type of diagnosis, and year of treatment. Results: Overall, only 48.9 percent of patients received treatment 30 days following discharge from detoxification. The rate was 76.4 percent for persons who received detoxification only while inpatients, while it was 20.8 percent for persons who received detoxification and rehabilitation while inpatients. Being in a behavioral carve-out was positively associated with a greater probability of subsequent follow-up treatment. In contrast, there was no difference by plan type once behavioral carve-outs were taken into account. There was no effect of cost-sharing on the probability of treatment following discharge for detoxification. Conclusion: Financial incentives may have less of an impact on whether someone receives treatment following detoxification than other aspects of benefit design and improved coordination between detoxification providers and treatment providers.

Learning Objectives:

Keywords: Substance Abuse Treatment, Managed Care

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.

Alcohol Use and Misuse: Understanding the Issues Poster Session

The 130th Annual Meeting of APHA