Open Access Research article

The use and costs of health and social services in patients with longstanding substance abuse

Corinna Vossius12*, Ingelin Testad12, Rune Skjæveland1 and Sverre Nesvåg3

Author Affiliations

1 Stokka Teaching Nursing Home, Lassaveien 10, Stavanger, N-4022 Norway

2 Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway

3 Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway

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BMC Health Services Research 2013, 13:185  doi:10.1186/1472-6963-13-185

Published: 22 May 2013

Abstract

Background

Persons with longstanding substance abuse might become increasingly dependent on help by the public, eventually requiring permanent care. In 2006 the municipality of Stavanger established a so-called addiction ward for these clients, comprising 17 beds at the largest municipal nursing home. We assumed that the residents of this ward were high consumers of health care and social services during the last months preceding their admission. The aim of the study was to register the type and extent of services that were claimed by this client group during the last six months prior to admission, and to calculate the costs that were caused. Further, we estimated the incremental costs for nursing home placement.

Methods

In 15 residents from the addiction ward the use of all welfare services during the six months prior to admission were registered. Costs were calculated by unit costs from a municipal, national and societal perspective.

Results

Mean total costs during this period were €32 474. Approximately half of these costs were borne by state-funded institutions, and half were borne by the municipality. The clients used a great variety of services aimed at subsistence, health care and support in independent living, while services aimed at drug withdrawal were not claimed. There was no correlation between costs and the level of functioning. The incremental costs for nursing home admission were borne by the municipalities.

Conclusion

Persons with longstanding substance abuse represent a group with a high use of welfare resources and hence cause high costs. However, our findings do not indicate any correlation between the amount of services rendered and the level of functioning. Further research should focus on the identification of the clients’ need for support in order to facilitate targeted interventions that might prevent further deterioration and, finally, the need for permanent care.

Keywords:
Substance abuse; Costs; Health care services; Social services