Case Management For Substance Abusers With Hiv/aids: A Randomized Clinical Trial

Sorensen, James L.; Dilley, James; London, Julie; Okin, Robert L.; Delucchi, Kevin; Phibbs, Ciaran S.

doi:10.1081/ada-120018843

Cited by 62 publications

(80 citation statements)

References 24 publications

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“…Many research studies describing possible interventions for homeless populations also note the substance abuse (Larimer et al, 2009;Saleh et al, 2002;Schumacher, Usdan, Milby, Wallace, & McNamara, 2000;Sorensen et al, 2003;Stein, Dixon, & Nyamathi, 2008;Tsemberis et al, 2004), mental health problems (Cheng et al, 2007;Chinman, Rosenheck, & Lam, 2000;Jones et al, 2003;Morse, 1999;Toro et al, 1997;Wasylenki, Goering, Lemire, Lindsey, & Lancee, 1993;Yanos, Felton, Tsemberis, & Frye, 2007), and dual diagnoses of those groups (Calsyn et al, 2005;Cheng & Kelly, 2008;Clark & Rich, 2003;Cunningham, Calsyn, Burger, Morse, & Klinkenberg, 2007;McGuire et al, 2009;O'Connell, Kasprow, & Rosenheck, 2009;Robbins, Callahan, & Monahan, 2009). Usually meeting mental health, substance abuse, or dual diagnosis criteria is defined in medical records, such as having a past diagnosis (McGuire et al, 2009) or psychiatric hospitalization in medical records (Jones et al, 2003) or a current Diagnostic and Statistical Manual of Mental Disorders (4th ed.…”

Section: Multi-need Populations and Homelessnessmentioning

confidence: 99%

Supportive Housing for Addicted, Incarcerated Homeless Adults

Hickert

Taylor

2011

J. of Social Service Res.

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Homeless populations often suffer from mental illness, substance abuse, and criminality. Interventions, such as supportive housing, can have positive impacts, although benefits can be limited. This study examined outcomes for clients (N = 102) of a new supportive housing intervention. Use of formal treatment, jail contact, and community stability were compared pre-and post-housing. Jail bookings and residential substance abuse treatment significantly declined post-housing, while clients improved in income level, access to food, and housing stability. Results from official justice and treatment system data suggest that supportive housing can lead to significant changes. Future research is necessary to understand the relationship between client characteristics and outcomes.

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Section: Multi-need Populations and Homelessnessmentioning

confidence: 99%

Supportive Housing for Addicted, Incarcerated Homeless Adults

Hickert

Taylor

2011

J. of Social Service Res.

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“…The sample comprised 190 adults with comorbid substance use disorders and HIV infection who were enrolled in a randomized clinical trial of a case management intervention (Sorensen et al ., 2003). Participants were recruited from the emergency department, inpatient wards and medical clinics at a public hospital.…”

Section: Participants and Proceduresmentioning

confidence: 99%

Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders

et al. 2004

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This study examined factors affecting medical service use among HIV-infected persons with a substance abuse disorder. The sample comprised 190 participants enrolled in a randomized trial of a case management intervention. Participants were interviewed about their backgrounds, housing status, income, alcohol and drug use problems, health status and depressive symptoms at study entry. Electronic medical records were used to assess medical service use. Poisson regression models were tested to determine the effects of need, enabling and predisposing factors on the dependent variables of emergency department visits, inpatient admissions and ambulatory care visits. During a two-year period, 71% were treated in the emergency department, 64% had been hospitalized and the sample averaged 12.9 ambulatory care visits. Homelessness was associated with higher utilization of emergency department and inpatient services; drug use severity was associated with higher inpatient and ambulatory care service use; and alcohol use severity was associated with greater use of emergency medical services. Homelessness and substance abuse exacerbate the health care needs of HIV-infected persons and result in increased use of emergency department and inpatient services. Interventions are needed that target HIV-infected persons with substance abuse disorders, particularly those that increase entry and retention in outpatient health care and thus decrease reliance on acute hospital-based services.

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“…However, the majority of published trials of interventions to reduce recurrent hospitalizations and ED visits by high frequency users do not employ predictive methodology. [14][15][16] This can result in misclassification bias, with interventions being directed to patients who may not benefit because their heavy use of costly health care services would have regressed on its own, with no intervention. Because health care resources are limited, it is essential that interventions target patients whose heavy use of the hospital will continue.…”

Section: Introductionmentioning

confidence: 99%

Medicaid Patients at High Risk for Frequent Hospital Admission: Real-Time Identification and Remediable Risks

et al. 2008

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Patients with frequent hospitalizations generate a disproportionate share of hospital visits and costs. Accurate determination of patients who might benefit from interventions is challenging: most patients with frequent admissions in 1 year would not continue to have them in the next. Our objective was to employ a validated regression algorithm to case-find Medicaid patients at high-risk for hospitalization in the next 12 months and identify intervention-amenable characteristics to reduce hospitalization risk. We obtained encounter data for 36,457 Medicaid patients with any visit to an urban public hospital from 2001 to 2006 and generated an algorithm-based score for hospitalization risk in the subsequent 12 months for each patient (0=lowest, 100= highest). To determine medical and social contributors to the current admission, we conducted in-depth interviews with high-risk hospitalized patients (scores 950) and analyzed associated Medicaid claims data. An algorithm-based risk score 950 was attained in 2,618 (7.2%) patients. The algorithm's positive predictive value was equal to 0.67. During the study period, 139 high-risk patients were admitted: 60 met inclusion criteria and 50 were interviewed. Fifty-six percent cited the Emergency Department as their usual source of care or had none. Sixty-eight percent had 91 chronic medical conditions, and 42% were admitted for conditions related to substance use. Sixty percent were homeless or precariously housed. Mean Medicaid expenditures for the interviewed patients were $39,188 and $84,040 per patient for the years immediately prior to and following study participation, respectively. Findings including high rates of substance use, homelessness, social isolation, and lack of a medical home will inform the design of interventions to improve community-based care and reduce hospitalizations and associated costs.

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Case Management For Substance Abusers With Hiv/aids: A Randomized Clinical Trial

Cited by 62 publications

References 24 publications

Supportive Housing for Addicted, Incarcerated Homeless Adults

Supportive Housing for Addicted, Incarcerated Homeless Adults

Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders

Medicaid Patients at High Risk for Frequent Hospital Admission: Real-Time Identification and Remediable Risks

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