Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management and one telecommunication case management, and the fourth was the control group. Results: Using a ratio of cost to days free from substance abuse, the case management groups were less cost-effective than the control group at 3 months, 6 months, and 12 months. The telecommunication case management was least cost-effective of the three case management conditions. Conclusion: Results from the analysis revealed case management is not cost-effective as a supplement to traditional drug treatment over a 12-month follow-up period.
Apsler, R., & Harding, W. M. (1991). Cost-effectiveness analysis of drug abuse treatment: Current status and recommendations for future research. In National Institute on Drug Abuse (Ed.), Background papers on drug abuse financing and services research(Research series No. 1., Pub. No. ADM 91-1777, pp. 58-81). Rockville, MD: U.S. Department of Health and Human Services.
2.
Ashery, R. S. (Ed.). (1992). Progress and issues in case management. National Institute on Drug Abuse Research Monograph, 127.
3.
Brindis, C., Pfeffer, R., Wolfe, A. (1995). A case management program for chemically dependent clients with multiple needs. Journal of Case Management, 4, 22-28.
4.
Drake, R. E., Mercer-McFadden, C., Mueser, K. T., McHugo, G. J.,& Bond, G. R. (1998). Review of integrated mental health and substance abuse treatment for patients with dual disorders. Schizophrenia Bulletin, 24, 589-608.
5.
Edmonds, E., Frank, R., Horgan, M., Robinson-Beale, R., & Weisner, C.,& the Institute of Medicine. (Eds.). (1997). Managing managed care: Quality improvement in behavioral health. Washington, DC: National Academy Press.
6.
Hall, J. A., & Carswell, C. (1996) Iowa case management: Treatment manua l. Unpublished manuscript.
7.
Hall, J. A., Carswell, C., Walsh, E., Huber, D., & Jampoler, J. (2002) Iowa case management: Innovative social casework. Social Work, 47, 132-243.
8.
Holder, H. D. (1998). Cost benefits of substance abuse treatment: An overviewof results from alcohol and drug abuse. Journal of Mental Health Policy and Economics, 1, 23-29.
9.
Hubbard, R. L., Marsden, M. E., Rachal, J. V., Harwood, H. J., Cavanaugh, E. R., & Ginzburg, H. M. (1989). Drug abuse treatment: A national study of effectiveness. Chapel Hill: University of North Carolina Press.
10.
Huber, D. L., Hall, J. A., & Vaughn, T. (2001). The dose of case management interventions. Lippincott's Case Management, 6(3), 119-126.
11.
Huber, D. L., Sarrazin, M. V., Vaughn, T.,& Hall, J. A. (2003). Evaluating the impact of case management dosage. Nursing Research, 52, 276-288.
12.
Katz, M. H., Cunningham, W. E., Mor, V., Andersen, R. M., Kellogg, T., Zierler, S., et al. (2000). Prevalence and predictors of unmet need for supportive services among HIV-infected person: Impact of case management. Medical Care, 38, 58-69.
13.
Lyons, J. S., Howard, K. I., O'Mahoney, M. T., & Lish, J. D. (1997). The measurement and management of clinical outcomes in mental health. New York: John Wiley.
14.
McLellan, A. T., Harvey, K., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The fifth addition of the addiction severity index. Journal of Substance Abuse Treatment, 9, 199-213.
15.
McLellan, A. T., Luborsky, L., O'Brien, C. P., Woody, G. E.,& Druley, K. A. (1982). Is treatment for substance abuse effective?Journal of Substance Abuse Treatment, 247, 1423-1428.
16.
McLellan, A. T., Luborsky, L., Woody, G. E.,& O'Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The addiction severity index. Journal of Nervous and Mental Disease, 168, 26-33.
17.
McLellan, A. T., Woody, G. E., Metzger, D., McKay, J., Durrell, J., Alterman, A.I., et al. (1996). Evaluating the effectiveness of addiction treatments: Reasonable expectations, appropriate comparisons. Milbank Quarterly, 74, 51-85.
18.
National Institute on Drug Abuse. (1998). Cost-benefit/ costeffectiveness research of drug abuse prevention: Implications for programming and policy, Rockville, MD: Author.
19.
Ouimette, P. C., Gima, K., Moss, R. H.,& Finney, J. W. (1999). Acomparative evaluation of substance abuse treatment IV. The effect of comorbid psychiatric diagnoses on amount of treatment, continuing care, and 1-year outcomes. Alcoholism: Clinical and Experimental Research, 23, 552-557.
20.
Ridgely, M. S. (1994). Practical issues in the application of case management to substance abuse treatment. Journal of Case Management, 3, 132-138.
21.
Robert Wood Johnson Foundation. (1994). Cost of addiction: Report 14. Princeton, NJ: Princeton University Press.
22.
Saleh, S. S., Vaughn, T. E., Hall, J. A., Levey, S., Fuortes, L., & Uden-Holmen, T. (2002). The effectiveness of case management in substance abuse treatment. Care Management Journals, 3, 172-177.
23.
Schwartz, M., & Baker, G. (1997). Improving publicly funded substance abuse treatment: The value of case management. American Journal of Public Health, 87, 1659-1665.
24.
Siegal, H. A., Fisher, J. H., Rapp, R. C., Kelliher, C. W., Wagner, J. H., O'Brien, W. F., et al. (1996). Enhancing substance abuse treatment with case management: Its impact on employment. Journal of Substance Abuse Treatment, 13, 93-98.
25.
Siegal, H. A., & Rapp, R. C. (Eds.). (1996). Case management and substance abuse treatment: Practice and experience. New York: Springer.
26.
Stout, R., Brown, P., Longabaugh, R., & Noel, N. (1996). Determinants of research follow-up participation in an alcohol treatment outcome trial. Journal of Consulting and Clinical Psychology, 64, 614-618.
27.
Vaughn, T., Sarrazin, M. V., Saleh, S. S., Huber, D. L., & Hall, J. A. (2002). Participation and retention in drug abuse treatment services research. Journal of Substance Abuse Treatment, 23, 387-397.
28.
Walton, M. A., Castro, F. G., & Barrington, E. H. (1994). The role of attributions in abstinence, lapse, and relapse following substance abuse treatment. Addictive Behaviors. 19, 319-331.
29.
Zimmerman, M., & Weinchowski, L. (1991) Revisiting health and mental health linkages: A policy whose time has come... again. Journal of Public Health, 12, 510-525.
30.
Zywiak, W. H., Hoffman, N. G., Stout, R. L., Hagberg, S., Floyd, A. S., & DeHart, S. S. (1999). Substance abuse treatment cost offsets vary with gender, age, and abstinence likelihood. Journal of Health Care Finance, 26, 33-39.
