Comorbid mental disorders among clients in addiction treatment: The costs of care
Bibliographic record
Abstract
Urbanoski, K., Rehm, J., Lange, S., & Popova, S. (2014). Comorbid mental disorders among clients in addiction treatment: The costs of care. The International Journal Of Alcohol And Drug Research, 3(4), 297-304. doi:http://dx.doi.org/10.7895/ijadr.v3i4.183Aims: To compare the volume and costs of services for clients with and without comorbid mental disorders in an addiction treatment system.Design: Secondary data analysis.Setting: Administrative data for the fiscal year 2010–2011 were abstracted from the Drug and Alcohol Treatment Information System (DATIS).Participants: Data represents all clients entering publicly funded services in Ontario in the fiscal year 2010–2011 (N = 41,953).Measures: Service costs were calculated using recent estimates of the cost per outpatient visit and day of residential care. Average numbers of visits/days per client, with and without mental disorders, were compared across gender and age subgroups.Findings: Overall, 22% of clients treated in 2010–2011 reported a past-year mental disorder. The costs of services for these clients were estimated to be between $18.5 and $40.3 million (in Canadian dollars), or 20% of the total service costs for the year. The largest difference in average volume of care was seen for residential treatment, where having a mental disorder was associated with seven fewer days of care. On average, during the period studied, among those without mental disorders, men spent 20 more days in residential care than did women.Conclusions: At the system-level in Ontario, clients with mental disorders did not account for a disproportionate amount of the total costs of care during the year. While these findings may signal a mismatch between the needs of clients with co-occurring disorders and their use of services, it is also possible that such clients receive additional care in other treatment sectors. Further study is warranted to explore potential unmet needs among clients with co-occurring disorders in addiction treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".