Costing substance misuse services.
Costing substance misuse services.
复制标题
计算药物滥用服务的成本。
作者：
Douglas Coyle;Christine Godfrey;Geoffrey Hardman;Duncan Raistrick
目标管理系统
制定一种方法来获取不同药物滥用服务的详细成本，并通过案例研究说明一些具体问题。
设计
将一年内所需资源、临床活动和患者特征的数据结合起来，以提供不同类型的临床事件和患者的详细成本。
设置
英国一个大型工业城市的一个公共资助的戒毒中心的临床服务。该科室主要为酗酒者和其他药物滥用者提供门诊服务，但也提供住院治疗。
参加者
超过 1500 名患者参与了分析，其中 75% 为男性，80% 年龄在 20 至 49 岁之间。近一半的客户将酒精作为主要滥用药物，阿片类药物使用者是第二大群体。
测量
由于人员类型和每个事件所需的时间都会被定期记录，因此可以按事件和患者进行详细的成本计算。对每个患者的每个单独事件的成本进行估计和求和，以给出 1992/3 财政年度按患者分类的成本估计。
研究结果
核心治疗门诊事件的平均成本为 48 英镑，新评估的成本为 87 英镑，但这些平均值隐藏了很大的差异。仅接受门诊治疗的患者每年的平均费用为 358 英镑；对于那些接受门诊和住院护理的人来说，这是 1857 年的英镑。平均而言，阿片类药物滥用者比酒精滥用者付出的代价更高。费用不均，10% 的患者费用占年度总费用的 56%。
结论
处理缺勤成本，包括所有资源的使用，以及应对不同个体和干预类型之间成本的巨大个体差异，是设计成本数字时的主要问题。成本数据很有用，但如果要用于改善患者服务，则需要将其与结果数据结合起来。
AIMS
To develop a methodology for obtaining the detailed costs of different substance misuse services and illustrate some of the specific problems by means of a case study.
DESIGN
Data on the resources required, clinical activity, and patient characteristics for one year were combined to provide detailed costs for different types of clinical events and patients.
SETTING
The clinical services of a publicly funded addiction unit in a large industrial city in the UK. The unit provides for alcohol and other drug misusers mainly on an outpatient basis but with inpatient care.
PARTICIPANTS
Over 1500 patients were included in the analysis with 75 per cent being male, and 80 per cent aged between 20 and 49. Nearly half of the clients had alcohol as their main drug of misuse with opiate users being the next largest group.
MEASUREMENT
Detailed costing by event and patient was possible as the staff type and time taken for each event were routinely recorded. A cost for each individual event was estimated and summed for each individual patient to give a cost estimate by patient for the financial year 1992/3.
FINDINGS
Core treatment outpatient events had an average cost of Pounds 48, with new assessments costing Pounds 87 but these averages hid high variations. The average cost per year for those receiving only outpatient care was Pounds 358; it was Pounds 1857 for those receiving both outpatient and inpatient care. Opiate misusers were on average more costly than alcohol misusers. The costs were skewed with 10 per cent of patients accounting for 56 per cent of the total annual costs.
CONCLUSIONS
Dealing with costs of non attendance, including all resource use, and coping with large individual variations in costs across individuals and intervention types are the main problems in devising cost figures. Cost data are useful but need to be combined with outcome data if they are to be used to improve patient services.
酗酒治疗抵消效应：成本模型。
DOI：
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发表时间：
1991
期刊：
Inquiry : a journal of medical care organization, provision and financing
影响因子：
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作者：
Goodman,AC;Holder,HD;Nishiura,E
通讯作者：
Nishiura,E