Revolving Treatment Door

This article points to the problems of just putting people through detox without doing follow up outpatient treatment.

With grim humor, some doctors in New York call them “frequent fliers” — addicts who check into hospital detoxification units so often that dozens of them spend more than 100 nights a year in those wards.

Through its Medicaid program, New York spends far more than other states on drug and alcohol treatment, including more than $300 million a year paid to hospitals for more than 30,000 detox patients. One reason for the high cost is that $50 million is spent just on the 500 most expensive patients, at a cost of about $100,000 a person. These patients check in and out of detox wards, on average, more than a dozen times a year — a practice that experts say would not be tolerated in most states.

In the state’s 2004 fiscal year, one patient was admitted to such units 26 times at 17 different hospitals around New York City, spending a total of 204 nights, Medicaid records show. In fiscal year 2005, there was one patient who spent 279 nights in detox wards, at a cost of about $300,000.

New York State spends more than enough money to provide all the needed treatment, but “the dollars are being spent in the wrong settings,” said Deborah S. Bachrach, the state’s Medicaid director. In Gov. Eliot Spitzer’s campaign to overhaul Medicaid, she said, “this is very high on our agenda.”

New York Times