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Financing Center of Excellence

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Welcome to the SAMHSA Financing Center of Excellence (COE) website. The Financing COE website features information about health care financing with a special focus on mental health and substance abuse (M/SU). Using blog-style posts, the SAMHSA Financing COE website offers original COE content as well as news, reports, briefs, scholarly article citations, legislation, and data sets regarding the financing of M/SU treatment and prevention. Stay tuned for site updates coming soon.

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Unforeseen Benefits: Addiction Treatment Reduces Health Care Costs

Posted on August 13, 2009 19:37

Topics: Rates/Reimbursement/Cost | Substance Use

Post Type:

This report from the Open Society Institute discusses how addiction treatment reduces health care costs.   

From the Open Society Institute:

Addiction is a pervasive yet treatable chronic health condition.  Often it occurs alongside other chronic diseases.  If untreated, the addicted person's medical care becomes more costly due to secondary health conditions.  When treated, addiction leads to better health care outcomes. 

This paper demonstrates how addiction treatment will contribute to containing costs in reforming America's health system.  Studies show that addiction treatment significantly reduces emergency room, inpatient and total health care costs. 

While the overall cost savings have not been documented, there are clear signs of the potential for savings.  For example:

  • One out of every 14 hospital stays - 2.3 million stays - was related to substance disorders in 2004, a federal study found.
  • Total medical costs were reduced 26 percent among one group of patients that received addiction treatment.
  • A group of at-risk alcohol users who received brief counseling recorded 20 percent fewer emergency department visits and 37 percent fewer days of hospitalization.

Full Report: http://www.soros.org/initiatives/treatmentgap/articles_publications/publications/paper1_20090714/paper1_20090714.pdf 


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NSDUH Report: Major Depressive Episode and Treatment Among Adolescents

Posted on August 13, 2009 19:32

Topics: Children | Medicaid | Mental Health | SAMHSA

Post Type:

This report, based on the National Survey of Drug Use and Health (NSDUH), found that, in 2007, 8.2 percent of adolescents (an estimated 2.0 million youths aged 12 to 17) experienced at least one major depressive episode (MDE) in the past year, and about two fifths (38.9 percent) of those received treatment for depression in the past year. Among adolescents with past year MDE, those with no health insurance coverage were much less likely than those with Medicaid/Children's Health Insurance Program or private health insurance to have received treatment (17.2 vs. 42.9 and 40.6 percent, respectively). 

Download the report from SAMHSA's OAS here: http://www.oas.samhsa.gov/2k9/youthDepression/MDEandTXTforADOL.pdf 


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Persisting Decline in Depression Treatment After FDA Warnings

Posted on August 13, 2009 19:24

Topics: Mental Health | Prescription Drugs | Trends

Post Type:

This study of depression treatment in the wake of FDA warnings regarding suicide in children taking antidepressants found that the frequency of depression diagnoses decreased and continues to decrease.  Substitute care did not compensate in non-adult groups and the authors conclude that the spillover effects of the FDA warnings were non-transitory, substantial, and diffuse in a large population.   

Libby, A. M., H. D. Orton, et al. (2009). Persisting decline in depression treatment after FDA warnings. Arch Gen Psychiatry. 66(6), 633-9. http://archpsyc.ama-assn.org/cgi/content/short/66/6/633

Authors: Anne M. Libby, Heather D. Orton, Robert J. Valuck.


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Non-Psychiatric Hospitalization of People with Mental Illness: Systematic Review

Posted on August 13, 2009 19:10

Topics: Mental Health

Post Type:

This article reviews the literature for evidence regarding outcomes for severely mentally ill patients hospitalized in general hospitals for non-psychiatric conditions.  The study concluded that nurses play a pivotal role with the mentally ill population but struggle to do so.  The authors suggest research to determine the best methods for promoting knowledge, positive attitudes and self-confidence in caring for patients with psychiatric co-morbidity among nurses.  

 

Zolnierek, C. D. (2009). Non-psychiatric hospitalization of people with mental illness: systematic review. J Adv Nurs. 65(8), 1570-1583. http://www.ncbi.nlm.nih.gov/pubmed/19493137 

 

Author: Cindy D. Zolnierek

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Trends in Antidepressant Utilization from 2001 to 2004

Posted on August 13, 2009 19:01

Topics: Mental Health | Prescription Drugs | Trends

Post Type:

This study found that, after years of increased use of antidepressants, a trend reversal began in the early 2000s which included decreasing rates of adequate antidepressant treatment.  The downward trend preceded FDA black-box warnings institute in 2004.   

Harman, J. S., M. J. Edlund, et al. (2009). Trends in antidepressant utilization from 2001 to 2004. Psychiatr Serv. 60(5), 611-6. DOI: 10.1176/appi.ps.60.5.611 http://psychservices.psychiatryonline.org/cgi/content/abstract/60/5/611 

Authors: Jeffrey S. Harman, Mark J. Edlund, John C. Fortne.


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Mental Illness in Nursing Homes: Variations Across States

Posted on August 13, 2009 18:46

Topics: Mental Health | State Data | Trends

Post Type:

This study found that significant variation across states in both the rates of mental illness among nursing home admissions and estimated rates of admission among people with mental illness.  The study also found that newly admitted individuals with mental illness were younger and more likely to become long-stay residents than non-mentally ill individuals.  The authors suggest that state-level mental health and nursing home factors may influence the likelihood of long-term nursing home use for people with mental illnesses.

Grabowski, D. C., K. A. Aschbrenner, et al. (2009). Mental illness in nursing homes: variations across States. Health Affairs, 28(3), 689-700. DOI: 10.1377/hlthaff.28.3.689 http://content.healthaffairs.org/cgi/content/abstract/28/3/689

Authors: David C. Grabowski, Kelly A. Aschbrenner, Zhanlian Feng, Vincent Mor.


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