AJPH Abstracts

H. C. Covington (rdc01@sprynet.com)
Sun, 7 Dec 1997 17:31:06 -0600

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H. C. Sonny Covington @ I CAN! America
Lafayette -  New Iberia, LA  70563-1722
(318) 364-6239  Fax 318-367-9141


Improving Publicly Funded Substance Abuse Treatment: The Value of Case
Michael Shwartz, PhD, Gregg Baker, Kevin P. Mulvey, PhD, and Alonzo Plough,
Objectives. This study evaluated the impact of case management on client
retention in treatment and short-term relapse for clients in the publicly
funded substance abuse treatment system.
Methods. A retrospective cohort design was used to study clients discharged
from the following four modalities in 1993 and 1994: short-term residential
(3112 clients), long-term residential (2888 clients), outpatient (7431
clients), and residential detox (7776 clients). Logistic regression models
were used to analyze the impact of case management after controlling for
baseline characteristics.

Results. The odds that case-managed clients reached a length of stay
previously identified as associated with more successful treatment were 1.6
(outpatient programs) to 3.6 (short-term residential programs) times higher
than the odds for non-case-managed clients. With the exception of
outpatient clients, the odds of case-managed clients' being admitted to
detox within 90 days after discharge (suggesting relapse) were about two
thirds those of non-case-managed clients. The odds of case-managed detox
clients' transitioning to post-detox treatment (a good outcome) were 1.7
times higher than the odds for non-case-managed clients.

Conclusions. Case management is a low-cost enhancement that improves
short-term outcomes of substance abuse treatment programs. (Am J Public
Health. 1997;87:1659-1664)

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