Yeom--ce article - The Journal of Mental Health Policy and...

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The Journal of Mental Health Policy and Economics J Ment Health Policy Econ 10 , 207-219 (2007) Cost-Effectiveness of a Mixed-Gender Aftercare Program for Substance Abuse: Decomposing Measured and Unmeasured Gender Differences Hyong Suk Yeom, 1 Donald S. Shepard 2 1 Ph.D., Department of Social Work, James Madison University, Harrisonburg, VA, USA 2 Ph.D., Heller School of Social Policy and Management, Brandeis University, Waltham, MA, USA Abstract Background: Most substance abuse programs are mixed-gender programs targeted largely at male substance abusers. Studies on gender differences in the cost-effectiveness of mixed-gender aftercare programs are rare. Little is known about how beneficial and efficient various aftercare treatments are for either female or male substance abusers in mixed-gender programs. Aims of the Study: Th iss tudyana lyzedgender differences in the cost-effectiveness of a mixed-gender relapse prevention aftercare program for substance abuse at Spectrum in Westborough, MA. Its aims are to contribute to methods of gender research by decomposing gender effects into measured and unmeasured characteristics, and to guide policy on addressing needs of female and male substance abusers in aftercare programs. Methods: This study examined data from a NIDA-funded project which enrolled 78 females and 141 males in a mixed-gender aftercare program in MA from 1994 to 1996. It first used the generalized estimating equations (GEE) model and the multivariate cost-effectiveness analysis to assess gender differences in the cost- effectiveness of treatment over two years of follow-up. The approach then allocated impacts on cost and outcomes to each measured characteristic (as the product of its coefficient times the gender difference) and attributed all remaining gender differences to unmeasured characteristics, termed the ‘‘pure’’ gender effect. Results: This aftercare treatment was effective for both men and women on proportion of days with any substance use compared to pre-treatment levels (-0.62 for men and -0.51 for women), but more reduc t ionappearedinmenthan in women. When the costs were standardized with the multivariate regression including client characteristics covariates, women cost more in aftercare treatment ($4435) than men ($4284). This greater cost for women was due to baseline characteristics associated with higher costs (e.g. less likely to have a profession); female gender per se actually reduced the
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Yeom--ce article - The Journal of Mental Health Policy and...

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