Impact of Case Management on Use of Health Services by Rural Clients in Substance Abuse Treatment

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Abstract
This research evaluates the effect of case management on the utilization of substance abuse, medical, and mental health services by substance abuse treatment clients subsequent to initiating residential treatment. The study also evaluates whether the proximity of the case manager to the treatment facility and use of a telecommunication system are related to case management effectiveness. Clients were randomly assigned to one of four conditions. Three conditions received case management according to the Iowa Case Management model and differed according to the location of the case manager and use of a telecommunication system. A fourth condition received standard treatment services. Clients provided feedback regarding service use for 12 months. Results indicated that when case managers were located at the treatment facility, they had an impact on clients' use of substance abuse treatment and medical services. Clients who were assigned to case managers located at the treatment facility used more treatment aftercare and medical services after admission to residential treatment than clients who received standard treatment. These effects were not found for clients assigned to case managers not located at the facility. Case management was not related to the use of mental health services subsequent to treatment.