HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fox, K Articles by Califano, J A Search for Related Content PubMed PubMed Citation Articles by Fox, K Articles by Califano, J A, Jr

Estimating the costs of substance abuse to the Medicaid hospital care program.

K Fox, J C Merrill, H H Chang and J A Califano, Jr

Center on Addiction and Substance Abuse, Columbia University, New York, NY 10019.

OBJECTIVES. The purpose of this study was to develop a model, using the epidemiologic tool of attributable risk, for estimating the cost of substance abuse to Medicaid. METHODS. Based on prior substance-use and morbidity research, population attributable risks for substance abuse-related diseases were calculated. (These risks measure the proportion of total disease cases attributable to smoking, drinking, and drug use.) The risks for each disease were applied to Medicaid hospital discharges and days on the 1991 National Hospital Discharge Survey that had these diseases as primary diagnoses. The cost of these substance abuse-related days were added to Medicaid hospital costs for direct treatment of substance abuse. RESULTS. More than 60 medical conditions involving 1100 diagnoses were identified, at least in part, as attributable to substance abuse. Factoring these substance abuse-related conditions into hospital costs, 1 out of 5 Medicaid hospital days, or 4 million days, were spent on substance abuse-related care in 1991. In 1994, this would account for almost $8 billion in Medicaid expenditures. CONCLUSIONS. The use of tobacco, alcohol, and drugs contributes significantly to hospital costs. To address rising costs, substance abuse treatment and prevention should be an integral part of any health care reform effort.

This article has been cited by other articles:

				J. Morgenstern, K. A. Blanchard, B. S. McCrady, K. H. McVeigh, T. J. Morgan, and R. J. Pandina Effectiveness of Intensive Case Management for Substance-Dependent Women Receiving Temporary Assistance for Needy Families Am J Public Health, November 1, 2006; 96(11): 2016 - 2023. [Abstract] [Full Text] [PDF]

				S. S. Bachman, M.-L. Drainoni, and C. Tobias Substance Abuse Treatment Services for People with Disabilities: Does Managed Care Prompt Innovation? Journal of Disability Policy Studies, January 1, 2003; 14(3): 154 - 162. [Abstract] [PDF]

				C. Laine, W. W. Hauck, M. N. Gourevitch, J. Rothman, A. Cohen, and B. J. Turner Regular Outpatient Medical and Drug Abuse Care and Subsequent Hospitalization of Persons Who Use Illicit Drugs JAMA, May 9, 2001; 285(18): 2355 - 2362. [Abstract] [Full Text] [PDF]

				The relative risks and etiologic fractions of different causes of death and disease attributable to alcohol, tobacco and illicit drug use in Canada Can. Med. Assoc. J., June 1, 2000; 162(12): 1669 - 1675.