Improving access, efficacy, and cost effectiveness of alcohol rehabilitation for poor patients.

Numerous alcoholics and alcohol abusers unknown to other agencies enter hospitals for treatment of alcohol-related illnesses. Two well-constructed studies focusing on poor clients enrolled in alcohol rehabilitation programs do not duplicate the long-term medical cost savings typical for higher income populations. Study limitations are indicated. Alcohol rehabilitation might avert or reduce potentially even higher long-term costs for poor clients as well as a host of social costs. It is important to demonstrate and improve the accessibility, efficacy, and cost effectiveness of alcohol treatment programs for the poor, especially since the viability and stability of public programs may be threatened due to competition with private facilities for insured and self-pay clients to subsidize the costs of treating the poor. Theoretical and practice issues and advances are discussed.