Multi-year service utilization trajectories among Drug Treatment Court graduates and non-graduates

Introduction: Substance use and mental disorders are prevalent among chronic offenders and associated with significant health and human service costs. Despite extensive computerized records, governmental data are seldom merged to assess longitudinal patterns of service and costs, limiting effective planning and evaluation. The Epidemiological Observatory (EO) integrates multi-year data from corrections, health, and social services for > 90,000 entrants to BC correctional services between 1998-2004.

Objectives: To employ the EO's merged health and correctional data sets to evaluate Vancouver's Drug Treatment Court (DTC), assessing trajectories of service utilization and associated costs differentiating DTC clients success and failure.

Methods: We examined the first DTC cohort (N=198), disaggregating two outcome groups (graduates and non graduates) using costs as a common metric for HHS (generally for substance use and mental health) and correctional involvement 4 years pre and 2 years post DTC.

Results: The groups differed markedly in patterns and median annual costs of services before and after DTC. Graduates showed increased yearly health costs ($709 to $2,579) and reduced correctional costs ($505 to zero); non-graduates showed little change in health costs ($466 to $633) but increased costs of corrections ($614 to $1,874).

Conclusion: This case study illustrates the application of the EO and merged inter-agency data to improve understanding of outcomes and service trajectories for high-risk sub-populations, and the association of increased levels of health services with positive outcomes. More broadly, these data support the goals of merged interagency data in surveillance and program evaluation.