Psychiatr Serv 50:1309-1315, October 1999
© 1999 American Psychiatric Association
The Cost of Treating Substance Abuse Patients With and Without Comorbid Psychiatric Disorders
Rani A. Hoff, Ph.D., M.P.H. and
Robert A. Rosenheck, M.D.
OBJECTIVE: Data from a national sample of patients with a primary diagnosis of a substance use disorder were analyzed to examine whether having a comorbid psychiatric diagnosis—a dual diagnosis—was associated with increased costs of health services over a six-year period and whether dually diagnosed patients used particular types of services more frequently. METHODS: A national sample of substance abuse patients being treated in Veterans Affairs (VA) facilities were classified into two groups—those with a dual diagnosis (N=3,069) and those with a single diagnosis of a substance use disorder (N=9,538). The sample was identified from two sources during a two-week period in 1990: outpatients in specialty substance abuse clinics and inpatients discharged with a substance-related diagnosis. Administrative data were used to track VA health care utilization and costs between 1991 and 1996. RESULTS: Dual diagnosis was associated with a significantly increased total cost of care over the six years, which was primarily explained by increased utilization of outpatient psychiatric and substance abuse services. Costs for both groups decreased over time, but they decreased faster among dually diagnosed patients. CONCLUSIONS: Having a comorbid psychiatric diagnosis appears to consistently increase the cost and utilization of services among patients with a primary diagnosis of a substance use disorder. These results are consistent with previous findings for dually diagnosed patients with a primary psychiatric diagnosis. The increased cost may simply reflect the greater severity of illness among dually diagnosed patients, but it may also indicate fragmented and inefficient service delivery.
This article has been cited by other articles:
|
|
|
|
 
I. Kooyman, K. Dean, S. Harvey, and E. Walsh
Outcomes of public concern in schizophrenia
The British Journal of Psychiatry,
August 1, 2007;
191(50):
s29 - s36.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Burnam and K. E. Watkins
Substance abuse with mental disorders: specialized public systems and integrated care.
Health Aff.,
May 1, 2006;
25(3):
648 - 658.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Belenko
Assessing Released Inmates for Substance-Abuse-Related Service Needs
Crime Delinquency,
January 1, 2006;
52(1):
94 - 113.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. E. Watkins, S. B. Hunter, M. A. Burnam, H. A. Pincus, and G. Nicholson
Review of Treatment Recommendations for Persons With a Co-occurring Affective or Anxiety and Substance Use Disorder
Psychiatr Serv,
August 1, 2005;
56(8):
913 - 926.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. K. Knudsen, P. M. Roman, and L. J. Ducharme
The Availability of Psychiatric Programs in Private Substance Abuse Treatment Centers, 1995 to 2001
Psychiatr Serv,
March 1, 2004;
55(3):
270 - 273.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. WEAVER, P. MADDEN, V. CHARLES, G. STIMSON, A. RENTON, P. TYRER, T. BARNES, C. BENCH, H. MIDDLETON, N. WRIGHT, et al.
Comorbidity of substance misuse and mental illness in community mental health and substance misuse services
The British Journal of Psychiatry,
October 1, 2003;
183(4):
304 - 313.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Dickey, S.-L. T. Normand, R. Drake, R. D. Weiss, H. Azeni, and A. Hanson
Limiting Inpatient Substance Use Treatment: What are the Consequences?
Med Care Res Rev,
September 1, 2003;
60(3):
332 - 346.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. Belenko, M. A. Lang, and L. A. O'connor
Self-Reported Psychiatric Treatment Needs Among Felony Drug Offenders
Journal of Contemporary Criminal Justice,
February 1, 2003;
19(1):
9 - 29.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. E. Drebing, R. Fleitas, A. Moore, C. Krebs, A. Van Ormer, W. Penk, C. Seibyl, and R. Rosenheck
Patterns in Work Functioning and Vocational Rehabilitation Associated with Coexisting Psychiatric and Substance Use Disorders
Rehabil Couns Bull,
October 1, 2002;
46(1):
5 - 13.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. A. Fuller, K. M. Shermock, M. Secic, J. S. Laich, and M. B. Durkin
Service Use and Costs Among VA Patients With Schizophrenia Taking Risperidone or Olanzapine
Psychiatr Serv,
July 1, 2002;
53(7):
855 - 860.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. E. Watkins, A. Burnam, F.-Y. Kung, and S. Paddock
A National Survey of Care for Persons With Co-occurring Mental and Substance Use Disorders
Psychiatr Serv,
August 1, 2001;
52(8):
1062 - 1068.
[Abstract]
[Full Text]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1999
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
