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Costs, Benefits, and Cost-Benefit of Gender-Sensitive Intensive Inpatient Treatment for Parenting and Nonparenting Substance Abusers
Gender-sensitive (GS) substance abuse treatment aims to provide services tailored to women's needs. Some services, such as assessment of parenting skills, focus on women's role as mothers and the familial impact of substance abuse. The current investigation examines the service utilization (healthcare, income assistance, criminal justice involvement) and earned income of 14,497 individuals who received substance abuse treatment at one of 13 mixed-gender, intensive inpatient programs (IIPs) varying in the level of gender-sensitive treatment provided. The cost of gender-sensitive treatment was calculated for each patient and was compared to service utilization and earned income two years preceding and following IIP treatment. It was expected that patients who were female, had children, and were receiving higher levels of gender-sensitive treatment would demonstrate greater reductions in service utilization and greater increases in earned income, offsetting the cost of treatment. Calculated benefits showed that service utilization mostly increased and earned income decreased after treatment, resulting in largely negative values. Analyses showed significant differences in treatment cost, benefits, and net benefits across levels of gender-sensitive treatment, generally demonstrating that the lowest level of gender-sensitive treatment was more costly and produced lower benefit values. Hierarchical regressions revealed significant relationships between key variables and specific benefits and net benefits, but not total net benefit. Although not completely aligned with project expectations, the results suggested that female gender, being a parent, and higher gender sensitivity variably impacted the costs and benefits of substance abuse treatment and remain important factors to consider in this line of research.