Dual Diagnosis Clinical Trial
Official title:
Matching, Outcomes and Costs in Substance Abuse/Psychiatric Treatment
This project�s goal is to improve the quality of care and reduce treatment costs for veterans with substance abuse and psychiatric problems.
Background:
This project�s goal is to improve the quality of care and reduce treatment costs for
veterans with substance abuse and psychiatric problems.
Objectives:
This project is evaluating a patient-treatment matching strategy to improve residential
treatment for substance abuse patients with psychiatric disorders. Its immediate objective
is to examine whether the matching strategy results in more effective and cost-effective
treatment in VA programs. We hypothesize that patients with severe clinical problems will
have better outcomes when they are matched to service-intensive programs; patients with
moderate problems will have better outcomes when they are matched to programs having a lower
intensity of services. For both patient groups, community treatment should prove to be more
cost-effective than hospital treatment.
Methods:
The project utilized a stratified randomized design. We paired each of three VA hospital
programs that treat dual diagnosis patients and are high on intensity with a nearby
high-intensity community residential facility (CRF) that contracts with the VA. We also
paired four VA hospital and four CRFs that are low on intensity. Veterans who applied for
substance abuse treatment at VA facilities were randomly assigned to either the VA hospital
or CRF. Patient assessments have been conducted at intake (N=230), discharge, and a 4-month
follow-up. Primary outcomes are patients� severity of substance abuse and psychiatric
problems. Secondary outcomes are patients� functional status and their VA and non-VA health
care utilization and its costs.
Status:
Completed.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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