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Published Online: May 2013

A Case and Care Management Program to Reduce Use of Acute Care by Clients With Substance Use Disorders

Abstract

Objective

The authors describe outcomes of a targeted case and care management program for persons with addictions utilizing a high level of acute services in Connecticut’s system of care.

Methods

Administrative and cost data were analyzed from five consecutive years (2004–2008) (N=165,305 clients).

Results

In the year after enrollment, acute care episodes fell by 56% compared with the year before enrollment, with a 19% increase in engagement in nonacute care services. Paid units of acute care fell by 62%; paid units of nonacute care increased by 63%. Costs of care were approximately 46% lower in the year after enrollment.

Conclusions

Findings suggest that outcomes can be improved while costs and acute care demands can be reduced through combined use of care management to identify high users and case management to engage them in lower levels of care. The system was able to reallocate acute care resources to nonacute services and serve additional clients.

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Go to Psychiatric Services
Go to Psychiatric Services

Cover: Portrait of a Woman, by William Beckman, ca. 1988. Oil on board. Photo credit: Jerry L. Thompson/Art Resource, New York City.

Psychiatric Services
Pages: 491 - 493
PubMed: 23632578

History

Published in print: May 2013
Published online: 15 October 2014

Authors

Details

Thomas A. Kirk, Jr., Ph.D.
Paul Di Leo, M.S., F.A.C.H.E.
Patricia Rehmer, M.S.N.
Dr. Kirk and Dr. Davidson are with the Department of Psychiatry, Yale University.
Mr. Di Leo and Ms. Rehmer are affiliated with the Connecticut Department of Mental Health and Addiction Services, Hartford.
Dr. Moy is with Advanced Behavioral Health, Middletown, Connecticut.
Send correspondence to Dr. Davidson at Yale Program for Recovery and Community Health, 319 Peck St., New Haven, CT 06513 ([email protected]).

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