INTEGRATED OUTPATIENT TREATMENT FOR MEDICALLY ILL ALCOHOLIC MEN - RESULTS FROM A QUASI-EXPERIMENTAL STUDY

Objective: This report documents the findings of a quasiexperimental s tudy of a new approach to treating medically ill alcoholics. The inter vention, the Alcohol Related Disorders (ARD) Clinic, consists of concu rrent alcohol treatment and medical care delivered by an interdiscipli nary team in an outpatient medical clinic at the Minneapolis Veterans Affairs Medical Center (MVAMC). Method: We compared 50 ARD patients wi th 50 patients who met eligibility for the clinic, but had to be refer red elsewhere because the clinic was full at the time (referred patien ts). Referred patients received medical care in other MVAMC clinics or in the community. Results: During the 2-year followup period, ARD pat ients returned for outpatient visits over three times as often as refe rred patients (p < .001). More referred patients received no follow-up care at MVAMC (p < .01). ARD patients had more frequent (p < .05) but briefer (p < .01) hospitalizations. Almost twice as many referred (32 %) as ARD patients (18%) died during the followup period. Referred pat ients ranged from 1.18 times less likely to 5.03 times more likely to die during follow-up than those in the ARD group (p = .11). ARD patien ts lived for an average of 82 days longer than referred patients, and each ARD clinic visit in the second follow-up year predicted an additi onal 3.5 days lived (p < .01). Conclusions: integrated outpatient trea tment for medically ill alcoholics appears to improve outpatient follo w-up and alter patterns of hospitalization when compared with standard approaches. Two-year mortality may have been reduced as a result.