How Residential Treatment Actually Reduces the Need and Cost of Healthcare

Doctor in white coat holding green file folder and pen

It’s no secret that the costs associated with healthcare can be quite momentous. Whether it’s routine dental care, a check-up with your primary care physicians, or something more exotic like appendix removal, even individuals with the best insurance coverage will often be required to make an out-of-pocket contribution. Meanwhile, any individual without health coverage is forced to foot the entire bill on his or her own, and depending on the scenario, that could mean hundreds, thousands, or even tens of thousands of dollars.

Clearly, healthcare is expensive. In a perfect world, we could choose to simply stay healthy and spare our overburdened wallets. However, until that happens, we’re going to have to find some way to pay for it.

Naturally, the costs associated with getting healthy often bring up the subject of addiction treatment. Of the many forms of care that are available, addiction treatment has a reputation for being among the most expensive, at least when it comes to non-surgical forms of care. Meanwhile, chronic substance abuse has been linked to a plethora of different mental and physical afflictions. But even before the complications that arise from one’s alcohol or drug use appear, millions upon millions of emergency departments visits occur from incidents related to substance abuse each year. So not only does rehabilitation have a cost, but those who are chemically dependent also incur numerous other health-related costs due to the physiological repercussions of their substance abuse.

At this point, you’re probably asking yourself the same question that we did. Specifically, what effect does residential treatment have on the amount a person spends on health-related services? As it happens, Foundations Recovery Network conducted an intensive study with patients receiving treatment for opioid addiction to find the answer.

Opioid Addiction and Healthcare

Ever since OxyContin hit the market in the mid-1990s, rates of opioid abuse have skyrocketed in the United States. Consequently, there have been more and more drug-related hospital visits every year. According to a study, there have been 64.1-percent and 99.4-percent increases in the number of drug-related inpatient stays and emergency department visits, respectively, between 2005 and 2014.1 Perhaps even more telling, heroin alone accounts for more than 20 percent of emergency department visits overall.2 And besides inpatient and emergency department visits, there are ambulatory services, visits to primary care providers and services provided by numerous specialists that incur costs. And when an individual requires healthcare multiple times in a year, the amount spent can grow at an exponential rate.

Services Received Before and After Residential Treatment

In the Foundations study, a group of 976 opioid-using patients were surveyed about the health care services that received in the six months prior to entering residential treatment. The same patients were surveyed again six months after completing treatment. The idea was to see if the completion of a residential treatment program would be an observable difference in the amount of healthcare services the patients received.

Over the six months prior to receiving residential treatment, there were 150 patients, or approximately 15 percent, who visited hospital emergency departments at least once for issues related to their substance abuse. However, over 220 patients, or approximately 23 percent, stayed overnight in hospitals at least once for substance abuse-related issues. As well, there were nearly 90 and more than 120 patients who made emergency department visits for mental health problems and general medical problems, respectively. For mental health and general medical problems, respectively, there were roughly 115 and 270 patients who stayed overnight in hospitals at least once. If we do the math, each patient had a 43-percent chance of needing an emergency department visit or overnight hospital stay for either substance abuse, mental health or general medical problems in the six months prior to receiving residential treatment.

The figures were quite different when the participants were asked about their need for healthcare services six months after completing residential treatment. For both substance abuse- and mental health-related problems, there were less than 30 participants who visited emergency departments. Additionally, less than 50 participants visited emergency departments for general medical problems. Even overnight hospital stays dropped significantly. Less than 50 patients required overnight hospital stays for drug-related problems while approximately 40 and 100 patients required overnight hospital stays for mental health and general medical problems, respectively.

For substance abuse problems in particular, this amounts to 80 percent less emergency department visits and over 77 percent less overnight hospital stays after the patients had received residential treatment. But mental health-related visits decreased an average of 80.7 percent while visits related to general medical problems decreased by an astounding 85 percent.

Less Care, Less Need, Less Cost

Now for the important question: What does this mean?

The patients in the Foundations study received far fewer healthcare services after completing residential treatment because their recoveries were followed by far fewer health complications. Although more research would be required to be certain, a reasonable interpretation would be that their opioid addictions were either a source or factor in many of the health problems they experienced prior to treatment.

One of the most significant revelations made by this study is the effect that a high-quality residential program can have on a person. It’s a well-known fact that health care has gotten extremely expensive over the years. In 1960, the average amount of annual healthcare spending for each American was just $146, but that amount has increased to over $9,500 today.3 While it’s true that addiction treatment can be pricey, studies such as this one show that the long-term benefit of residential treatment far outweighs its initial cost.

Each time an addicted individual visits a hospital emergency department, visits his or her primary care physician for an injury or needs to see a specialist for some other reason, he or she incurs a cost. Although health coverage often bears most of the financial burden, the cost of these healthcare services continue to accumulate over time. A high-quality residential program may have a high cost — if it’s not covered by one’s health insurance plan, of course — but the benefit of improved overall health will likely mean far less spending on healthcare services over time.

Written by Dane O’Leary

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