FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2185909061> ?p ?o ?g. }

• W2185909061 endingPage "77" @default.
• W2185909061 startingPage "65" @default.
• W2185909061 abstract "BACKGROUND: Health services researchers have increasingly used hazard functions to examine illness or treatment episode lengths and related treatment utilization and treatment costs. There has been little systematic hazard analysis, however, of mental health/substance abuse (MH/SA) treatment episodes. AIMS OF THE STUDY: This article uses proportional hazard functions to characterize multiple treatment episodes for a sample of insured clients with at least one alcohol or drug treatment diagnosis over a three-year period. It addresses the lengths and timing of treatment episodes, and the relationships of episode lengths to the types and locations of earlier episodes. It also identifies a problem that occurs when a portion of the sample observations is ǣpossibly censored. Failure to account for sample censoring will generate biased hazard function estimates, but treating all potentially censored observations as censored will overcompensate for the censoring bias. METHODS: Using insurance claims data, the analysis defines health care treatment episodes as all events that follow the initial event irrespective of diagnosis, so long as the events are not separated by more than 30 days. The distribution of observations ranges from 1 day to 3 years, and individuals have up to 10 episodes. Due to the data collection process, observations may be right censored if the episode is either ongoing at the time that data collection starts, or when the data collection effort ends. The Andersen-Gill (AG) and Wei-Lin-Weissfeld (WLW) estimation methods are used to address relationships among individuals multiple episodes. These methods are then augmented by a probit censoring model that estimates censoring probability and adjusts estimated behavioral coefficients and related treatment utilization and treatment costs. There has been little systematic hazard analysis, however, of mental health/substance abuse (MH/SA) treatment episodes. RESULTS: Five sets of variables explain episode duration: (i) individual; (ii) insurance; (iii) employer; (iv) binary, indicating episode diagnosis, location, and sequence; and (v) linkage, relating current diagnoses to previous diagnoses in a sequence. Sociodemographic variables such as age or gender have impacts at both the individual and at the firm level. Coinsurance rates and deductibles also have impacts at the individual and the firm levels. Binary variables indicate that surgical/outpatient episodes were the shortest, and psychiatric/outpatient episodes were the longest. Linkage variables reveal significant impacts of prior alcoholism, drug, and psychiatric episodes on the lengths of subsequent episodes. DISCUSSION: Health care treatment episodes are linked to each other both by diagnosis and by treatment location. Both the AG and the WLW models have merit for treating multiple episodes. The AG model permits more flexibility in estimating hazards, and allows researchers to model impacts of prior diagnoses on future episodes. The WLW model provides a convenient way to examine impacts of sociodemographic variables across episodes. It also provides efficient pooled estimates of coefficients and their standard errors. LIMITATIONS: The insurance claims data set covers 1989 through 1991, predating current managed care plans. It cannot identify untreated substance abusers, nor can it identify those with out-of-plan use. It provides treatment information only if services are covered by the insurance plan and are defined with a substance abuse diagnosis code. Like medical records, insurance claims will not specify substance abuse treatment received within the context of other health care (and thus identified by a non-substance abuse diagnosis code) or community services. IMPLICATIONS FOR POLICY AND RESEARCH: This article characterizes multiple health treatment episodes for a sample of insured clients with at least one alcohol or drug treatment diagnosis within a three-year period. We identify both individual and employer effects on episode length. We find that episode lengths vary by the diagnosis type, and that the lengths (and by inference cost and utilization) may depend on the treatments that occurred in previous episodes. We also recognize that health care or illness episodes may be ongoing at times of health care events prior to the ends of data collection periods, leading to uncertain episode lengths. Corresponding estimates of costs or utilization are also uncertain. We provide a method that adjusts the episode lengths according to the probability of censoring." @default.
• W2185909061 created "2016-06-24" @default.
• W2185909061 creator A5014059976 @default.
• W2185909061 creator A5033657464 @default.
• W2185909061 creator A5046091537 @default.
• W2185909061 creator A5050557204 @default.
• W2185909061 creator A5073771690 @default.
• W2185909061 date "2001-06-01" @default.
• W2185909061 modified "2023-09-23" @default.
• W2185909061 title "Estimating Determinants of Multiple Treatment Episodes for Substance Abusers." @default.
• W2185909061 cites W1574051700 @default.
• W2185909061 cites W1580788756 @default.
• W2185909061 cites W1817179733 @default.
• W2185909061 cites W1876878142 @default.
• W2185909061 cites W1973297047 @default.
• W2185909061 cites W1986229129 @default.
• W2185909061 cites W1986452493 @default.
• W2185909061 cites W1986705681 @default.
• W2185909061 cites W1996497116 @default.
• W2185909061 cites W2022993864 @default.
• W2185909061 cites W2028554504 @default.
• W2185909061 cites W2051405248 @default.
• W2185909061 cites W2072703138 @default.
• W2185909061 cites W2076313071 @default.
• W2185909061 cites W2090237651 @default.
• W2185909061 cites W2092648747 @default.
• W2185909061 cites W2093107759 @default.
• W2185909061 cites W2093715788 @default.
• W2185909061 cites W2098605462 @default.
• W2185909061 cites W2186527974 @default.
• W2185909061 cites W2335563523 @default.
• W2185909061 cites W2433235966 @default.
• W2185909061 cites W3121411107 @default.
• W2185909061 cites W597436214 @default.
• W2185909061 cites W90717837 @default.
• W2185909061 cites W161914606 @default.
• W2185909061 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/11967467" @default.
• W2185909061 hasPublicationYear "2001" @default.
• W2185909061 type Work @default.
• W2185909061 sameAs 2185909061 @default.
• W2185909061 citedByCount "3" @default.
• W2185909061 countsByYear W21859090612017 @default.
• W2185909061 crossrefType "journal-article" @default.
• W2185909061 hasAuthorship W2185909061A5014059976 @default.
• W2185909061 hasAuthorship W2185909061A5033657464 @default.
• W2185909061 hasAuthorship W2185909061A5046091537 @default.
• W2185909061 hasAuthorship W2185909061A5050557204 @default.
• W2185909061 hasAuthorship W2185909061A5073771690 @default.
• W2185909061 hasConcept C105795698 @default.
• W2185909061 hasConcept C118552586 @default.
• W2185909061 hasConcept C126322002 @default.
• W2185909061 hasConcept C134362201 @default.
• W2185909061 hasConcept C137668524 @default.
• W2185909061 hasConcept C144024400 @default.
• W2185909061 hasConcept C149923435 @default.
• W2185909061 hasConcept C207103383 @default.
• W2185909061 hasConcept C33923547 @default.
• W2185909061 hasConcept C40010229 @default.
• W2185909061 hasConcept C44249647 @default.
• W2185909061 hasConcept C67257552 @default.
• W2185909061 hasConcept C71924100 @default.
• W2185909061 hasConceptScore W2185909061C105795698 @default.
• W2185909061 hasConceptScore W2185909061C118552586 @default.
• W2185909061 hasConceptScore W2185909061C126322002 @default.
• W2185909061 hasConceptScore W2185909061C134362201 @default.
• W2185909061 hasConceptScore W2185909061C137668524 @default.
• W2185909061 hasConceptScore W2185909061C144024400 @default.
• W2185909061 hasConceptScore W2185909061C149923435 @default.
• W2185909061 hasConceptScore W2185909061C207103383 @default.
• W2185909061 hasConceptScore W2185909061C33923547 @default.
• W2185909061 hasConceptScore W2185909061C40010229 @default.
• W2185909061 hasConceptScore W2185909061C44249647 @default.
• W2185909061 hasConceptScore W2185909061C67257552 @default.
• W2185909061 hasConceptScore W2185909061C71924100 @default.
• W2185909061 hasIssue "2" @default.
• W2185909061 hasLocation W21859090611 @default.
• W2185909061 hasOpenAccess W2185909061 @default.
• W2185909061 hasPrimaryLocation W21859090611 @default.
• W2185909061 hasRelatedWork W1486152899 @default.
• W2185909061 hasRelatedWork W1583505921 @default.
• W2185909061 hasRelatedWork W1971463050 @default.
• W2185909061 hasRelatedWork W2034719019 @default.
• W2185909061 hasRelatedWork W2092260740 @default.
• W2185909061 hasRelatedWork W2154913456 @default.
• W2185909061 hasRelatedWork W2330149481 @default.
• W2185909061 hasRelatedWork W2409974626 @default.
• W2185909061 hasRelatedWork W2525501974 @default.
• W2185909061 hasRelatedWork W3123546659 @default.
• W2185909061 hasVolume "4" @default.
• W2185909061 isParatext "false" @default.
• W2185909061 isRetracted "false" @default.
• W2185909061 magId "2185909061" @default.
• W2185909061 workType "article" @default.