LENGTH OF STAY AS AN OUTCOME IN AN ERA OF MANAGED CARE - AN EMPIRICAL-STUDY

Longer length of stay (LOS) in substance abuse treatment, a standard m easure of treatment success, conflicts with pressures from managed car e. To maintain LOS as an outcome, we identified for four modalities, L OS categories such that program completion rates were relatively const ant within category and differed among categories. We validated the cu toffs by showing that future utilization over a 2-year period by clien ts differed by category. Clients in the long-LOS category used the sys tem in a way consistent with more successful treatment. Thus, rather t han using increase in LOS as an outcome, one can use increase in the p ercentage of clients reaching the long-LOS category. Categories were d eveloped and utilization analyzed for discharges from publicly funded Boston treatment programs between 1/92 and 12/94 from the following mo dalities: short-term residential (5,462 discharges), long-term residen tial (5,086 discharges), outpatient (13,656 discharges), and deter (19 ,965 discharges). (C) 1997 Elsevier Science Inc.