依存症治療と初等医療の統合:ランダム化制御試験
C Weisner1, J Mertens, S Parthasarathy
1Kaiser Permanente Division of Research, 3505 Broadway, 12th Floor, Oakland, CA 94611, USA.
JAMA
|October 12, 2001
まとめ
統合された医療および薬物乱用治療は,薬物乱用に関連する医療状態 (SAMCs) の患者の禁欲率を大幅に改善します. この調整されたケアモデルは,この脆弱な集団に対して,費用対効果の高い利益を提供します.
科学分野:
- 依存症医学 薬物中毒医学
- 公衆衛生は公衆衛生である.
- ヘルスケア・マネジメント・ヘルスケア・マネジメント
背景:
- 薬物乱用患者における併発性疾患の高い罹患率.
- 薬物乱用治療プログラムにおける医療サービスの統合は限られている.
- この集団における未治療の疾患に関連した重要な医療費.
研究 の 目的:
- 統合された医療および薬物乱用ケアモデルと独立した医療および薬物乱用ケアモデルの治療結果と費用を比較します.
- 薬物乱用関連疾患 (SAMC) の患者に対する統合医療の具体的な影響を評価する.
主な方法:
- 592人の成人の患者が参加したランダム化対照試験で,化学依存症プログラムを実施した.
- 統合ケアモデル (薬物依存症治療内のプライマリケア) と独立ケアモデル (別々のサービス) の比較.
- 禁欲率,治療利用率,および6ヶ月のフォローアップ時の費用の評価.
主要な成果:
- 統合的ケアグループと独立したケアグループとの間で,全体的な禁欲率の有意な差はありません.
- SAMCを投与した患者は,統合治療群で著しく高い禁欲率を示した (69%対55%,P=.006).
- SAMC患者に対する統合医療は,追加の禁欲患者1人につき1581ドルという費用対効果比を示した.
結論:
- 統合された医療および薬物乱用治療は,SAMCの患者にとって有益です.
- 統合モデルは,同時に発生する条件を管理するための費用対効果の高いアプローチである可能性があります.
- 研究結果は,薬物乱用患者および併発性疾患の患者に対する政策変更と新しい治療戦略を支持しています.
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