Alcoholism treatment and medical care costs from Project MATCH

Aims. This paper examines the costs of medical care prior to and following initiation of alcoholism treatment as part of a study of patient matching t o treatment modality. Design. Longitudinal study with pre- and post-treatme nt initiation. Measurements. The total medical care costs for inpatient and outpatient treatment for patients participating over a spall of 3 years po st-treatment. Setting. Three treatment sites at two of the nine Project MAT CH locations (Milwaukee, WI and Providence, RI). Participants. Two hundred and seventy-nine patients. Intervention. Patients Mere randomly assigned to one of three treatment modalities: a 12-session cognitive behavioral thera py (CBT), a four-session motivational enhancement therapy (MET) or a 12-ses sion Twelve-Step facilitation (TSF) treatment over 12 weeks. Findings. Tota l medical care costs declined from pre- to post-treatment overall and for e ach modality. Matching effects independent of clinical prognosis showed tha t MET has potential for medical-care cost-savings. However, patients with p oor prognostic characteristics (alcohol dependence, psychiatric severity an d/or social network support for drinking) have better cost-savings potentia l with CBT and/or TSF. Conclusions. Matching variables have significant imp ortance in increasing the potential for medical-care cost-reductions follow ing alcoholism treatment.