Health Care Utilization After Paraprofessional-administered Substance Use Screening, Brief Intervention, and Referral to Treatment
A Multi-level Cost-offset Analysis
Dados Bibliográficos
| ID | 9099271 |
|---|---|
| Autores | Jason Paltzer (0000-0001-6049-8064, Population Health Institute, University of Wisconsin-Madison, College of Nursing & Health Care Professions, Grand Canyon University, autor correspondente), D Paul Moberg (0000-0002-7475-7909, University of Wisconsin–Madison), Margaret E Burns (0000-0002-0625-2861, University of Wisconsin–Madison), Marguerite Burns (Department of Population Health Sciences, University of Wisconsin, Madison, WI), Richard L Brown (ConcertoHealth, Kalamazoo, MI) |
| Ano | 2019 |
| Volume | 57 |
| Fascículo | 9 |
| Páginas | 673-679 |
| Data de publicação | 2019-09-01 |
| Peer Reviewed | Sim |
| Open Access | Não |
| Tipo | ARTICLE |
| Periódico | Medical Care (JOURNAL) |
| Identificadores do periódico | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Editora | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001162 |
| PMID | 31295165 |
| OpenAlex | W2959163470 |
| Idioma | EN |
| Citações recebidas | 3 |
| Referências citadas | 38 |
BACKGROUND: Authorities recommend universal substance use screening, brief intervention, and referral to treatment (SBIRT) for all (ie, universal) adult primary care patients. OBJECTIVE: The objective of this study was to examine long-term (24-mo) changes in health care utilization and costs associated with receipt of universal substance use SBIRT implemented by paraprofessionals in primary care settings. RESEARCH DESIGN: This study used a difference-in-differences design and Medicaid administrative data to assess changes in health care use among Medicaid beneficiaries receiving SBIRT. The difference-in-differences estimates were used in a Monte Carlo simulation to estimate potential cost-offsets associated with SBIRT. SUBJECTS: The treatment patients were Medicaid beneficiaries who completed a 4-question substance use screen as part of an SBIRT demonstration program between 2006 and 2011. Comparison Medicaid patients were randomly selected from matched clinics in Wisconsin. MEASURES: The study includes 4 health care utilization measures: outpatient days; inpatient length of stay; inpatient admissions; and emergency department admissions. Each outcome was assigned a unit cost based on mean Wisconsin Medicaid fee-for-service reimbursement amounts. RESULTS: We found an annual increase of 1.68 outpatient days (P=0.027) and a nonsignificant annual decrease in inpatient days of 0.67 days (P=0.087) associated with SBIRT. The estimates indicate that the cost of a universal SBIRT program could be offset by reductions in inpatient utilization with an annual net cost savings of $782 per patient. CONCLUSIONS: Paraprofessional-delivered universal SBIRT is likely to yield health care cost savings and is a cost-effective mechanism for integrating behavioral health services in primary care settings
Brief intervention · Emergency department · Family medicine · Health care · Inpatient care · Medicaid · Medical emergency · Psychological intervention · Referral · Reimbursement · Emergency Medicine · Medicine · Nursing · Opioid Use Disorder Treatment · Smoking Behavior and Cessation · Substance Abuse Treatment and Outcomes
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| Obras citantes distintas | 3 |
|---|---|
| Citações por ano | 1 |
| Intervalo de citações | 2023 - 2026 (4) |
| Velocidade de citação | current |
| Altamente citado | Não |
| Tipos de citação | Neutras: 2 |