Regular article
On-site medical care in methadone maintenance: Associations with health care use and expenditures

https://doi.org/10.1016/j.jsat.2006.07.008Get rights and content

Abstract

To evaluate whether long-term drug treatment with on-site medical care is associated with diminished inpatient and outpatient service use and expenditures, we linked prospective interview data to concurrent Medicaid claims of drug users in a methadone program with comprehensive medical services. Patient care was classified as follows: long-term (≥6 months) drug treatment with on-site usual source of medical care (linked care), long-term drug treatment only, or neither. Multivariate analyses adjusted for visit clustering within patients (n = 423, with 1,161 person-years of observation). After adjustment, linked care participants had more outpatient visits (p < .001), fewer emergency department (ED) visits (24% vs. 33%, p = .02) and fewer hospitalizations (27% vs. 40%, p = .002) than the “neither” group. Ambulatory care expenditures in the linked group were increased, whereas expenditures for other services were similar or reduced. Long-term drug treatment with on-site medical care was associated with increased ambulatory care, less ED and inpatient care, and no net increase in expenditures.

Keywords

Substance abuse treatment
Drug users
Injection drug users
Methadone maintenance
Integrated services

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1

Dr. Gourevitch completed the majority of this work while at Montefiore Medical Center and the Albert Einstein College of Medicine.

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