 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Mary F. Brolin, MA1, Michael Shwartz, PhD2, Lee Panas, MS1, and Elsa Elliott, MA1. (1) Health and Addictions Research, Inc., 100 Boylston Street, Suite 300, Boston, MA 02116, 617-266-9219 ext. 117, mbrolin@har.org, (2) Professor of Health Care and Operations Management, Boston University, 595 Commonwealth Avenue, Room 665, Boston, MA 02215-1704
This analysis examined the impact of case management on outcomes for homeless, dually diagnosed, and criminal justice clients receiving treatment in publicly funded substance abuse treatment programs in Boston, Massachusetts. A retrospective cohort design assessed clients in short-term residential, long-term residential, and outpatient treatment and clients receiving detoxification (detox) services. The sample included 4,031 homeless clients, 2,932 dually diagnosed clients, 6,290 criminal justice clients, and a comparison group of 9,572 clients who did not fit into any of the three special populations. Logistic regression models analyzed the impact of case management on treatment outcomes controlling for baseline characteristics. The intermediate outcomes assessed were long length of stay, transition to another type of treatment within 30 days of discharge, and admission to detox within 90 days of discharge. Overall, the findings showed that case management improved intermediate outcomes for clients in each of the special populations as well as for comparison clients. For clients in most of the types of treatment and for those receiving detox, case management improved the odds of longer retention and of transitioning to another level of care when appropriate. The only clients case management protected from the negative outcome of being admitted to detox within 90 days of discharge were homeless clients in short-term residential treatment. The findings of this analysis support the use of case management as standard practice in substance abuse treatment. They also support public policies that coordinate case management across relevant systems, such as mental health, housing, Medicaid, and the legal system.
Learning Objectives:
Keywords: Case Management, Special Populations
Related Web page: neds.calib.com/products/abstract.cfm?ProductID=400
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.