Costs of opioid overdose education and naloxone distribution in New York City.
Costs of opioid overdose education and naloxone distribution in New York City.
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DOI：
10.1080/08897077.2021.1986877
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发表时间：
2022
期刊：
影响因子：
3.5
通讯作者：
Schackman, Bruce R.
中科院分区：
文献类型：
--
作者：
Behrends, Czarina N.;Gutkind, Sarah;Winkelstein, Emily;Wright, Monique;Dolatshahi, Jennifer;Welch, Alice;Paone, Denise;Kunins, Hillary V.;Schackman, Bruce R.
纳洛酮是一种阿片类拮抗剂药物，可由非专业人员或医学专业人员使用，以逆转阿片类药物过量，降低过量死亡率。2017年，成本被确定为在纽约市(NYC)提供扩大过量教育和纳洛酮分发(OEND)的潜在障碍。我们估计了纽约市不同类型阿片类药物过量预防计划(OOPP)的OEND成本。2017年12月至2019年9月，我们在纽约市的11个注射器服务项目(SSP)和10个有目的地抽样的非SSP项目中采访了纳洛酮协调员。样本包括不同的非SSP项目类型、项目规模和OEND资金来源。我们使用微观成本计算方法计算一次性启动成本和持续运营成本，从项目角度估计OEND活动的人员、时间和材料成本，但不包括纳洛酮试剂盒成本。实施OEND计划需要SSP的一次性启动成本中值为874美元，不包括管理费用的其他计划的启动成本中值为2,548美元，其中80%的成本用于培训员工的时间和差旅。每名经过培训的工作人员的平均支出为90美元，而非战略合作伙伴的支出为每名工作人员150美元。不包括管理费用的OEND计划活动的月成本中值，SSP为1,579美元，非SSP为2,529美元。非SSP的成本因规模而异，与单站点计划相比，较大的多站点计划的成本中值更高。不包括管理费用的每个试剂盒的估计中值成本分别为19美元和25美元，而非SSP的每个试剂盒的中位数成本分别为36美元和43美元。OEND的运营成本因计划类型和站点数量而异。资助者应该考虑到，向OEND计划免费提供纳洛酮并不能弥补全部运营成本。应考虑在不同类型的OEND环境中进一步探索成本效益和计划效率。
Naloxone is an opioid antagonist medication that can be administered by lay people or medical professionals to reverse opioid overdoses and reduce overdose mortality. Cost was identified as a potential barrier to providing expanded overdose education and naloxone distribution (OEND) in New York City (NYC) in 2017. We estimated the cost of delivering OEND for different types of opioid overdose prevention programs (OOPPs) in NYC. We interviewed naloxone coordinators at 11 syringe service programs (SSPs) and 10 purposively sampled non-SSPs in NYC from December 2017 to September 2019. The samples included diverse non-SSP program types, program sizes, and OEND funding sources. We calculated one-time start up costs and ongoing operating costs using micro-costing methods to estimate the cost of personnel time and materials for OEND activities from the program perspective, but excluding naloxone kit costs. Implementing an OEND program required a one-time median start-up cost of $874 for SSPs and $2,548 for other programs excluding overhead, with 80% of those costs attributed to time and travel for training staff. SSPs spent a median of $90 per staff member trained and non-SSPs spent $150 per staff member. The median monthly cost of OEND program activities excluding overhead was $1,579 for SSPs and $2,529 for non-SSPs. The costs for non-SSPs varied by size, with larger, multi-site programs having higher median costs compared to single-site programs. The estimated median cost per kit dispensed excluding and including overhead was $19 versus $25 per kit for SSPs, and $36 versus $43 per kit for non-SSPs, respectively. OEND operating costs vary by program type and number of sites. Funders should consider that providing free naloxone to OEND programs does not cover full operation costs. Further exploration of cost-effectiveness and program efficiency should be considered across different types of OEND settings.
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DOI：
10.1111/add.13265
发表时间：
2016-05
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Bird SM;McAuley A;Perry S;Hunter C
通讯作者：
Hunter C
影响因子：
2.2
作者：
Rees, Daniel I.;Sabia, Joseph J.;Latshaw, Joshua
通讯作者：
Latshaw, Joshua
影响因子：
3.1
作者：
Spelman, Juliette F.;Peglow, Stephanie;Becker, William C.
通讯作者：
Becker, William C.
影响因子：
3.1
作者：
Teixeira, Paul A.;Bresnahan, Marie P.;Schackman, Bruce R.
通讯作者：
Schackman, Bruce R.
影响因子：
3.5
作者：
Oldfield, Benjamin J.;Tetrault, Jeanette M.;Capurso, Noah A.
通讯作者：
Capurso, Noah A.