Using the DATCAP and ASI to estimate the costs and benefits of residential addiction treatment in the State of Washington
Using the DATCAP and ASI to estimate the costs and benefits of residential addiction treatment in the State of Washington
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DOI：
10.1016/s0277-9536(02)00060-6
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发表时间：
2002-12-01
影响因子：
5.4
通讯作者：
Carney, M
中科院分区：
文献类型：
--
作者：
French, MT;Salomé, HJ;Carney, M
资助机构和政策制定者经常批评住院成瘾治疗，因为住院服务的成本通常高于门诊服务，而且尚不清楚对于大多数客户来说，结果是否明显更好。为了解决这些问题，住院治疗的支持者需要经济证据来证明进一步投资这种模式而不是强度较低和成本较低的选择。最近的研究开发了使用药物滥用治疗成本分析程序（DATCAP）和成瘾严重程度指数（ASI）对成瘾治疗进行综合经济评估的方法和经验指南。本研究应用这些方法和指南来估计美国华盛顿州五个为公共资助客户服务的项目的住院成瘾治疗的经济成本和效益。使用 DATCAP 现场收集的数据以及与治疗就诊相关的机会成本估算得出了特定于计划和客户的经济成本估算。经济效益是根据客户在治疗开始时和出院后 6 个月时使用 ASI 自我报告的信息计算得出的。结果类别包括住院服务、就业、医疗和精神状况以及犯罪活动。结果表明，五个项目的治疗服务平均每周经济成本在 463 美元到 703 美元之间。对于完成基线和后续调查问卷的所有受试者（N = 222；82%），平均（每位客户）治疗经济成本为 4912 美元（包括 3650 美元的计划成本和 1262 美元的客户成本）。平均（每个客户）总经济效益为 21,329 美元，因此平均净效益估计为 16,418 美元，效益成本比为 4.34。总经济效益和净经济效益与性别、种族、宗教偏好以及吸毒和法律地位的基线 ASI 综合得分显着相关。详细的敏感性分析并没有改变定性研究结果。这项研究提供了确凿的证据，表明对于华盛顿州的这个项目样本，住宅成瘾治疗的经济效益显着超过了经济成本。尽管结果不一定适用于私人付费客户或美国其他州的客户，但这些方法是基于广泛使用的数据收集工具和公认的经济原则。因此，将这项研究扩展到其他客户、国家和模式应该是可行且直接的。 (C) 2002 Elsevier Science Ltd. 保留所有权利。
Funding agencies and policy makers often criticize residential addiction treatment because the cost of residential services is typically higher than for outpatient services and it is unclear whether the outcomes are significantly better for most clients. To address these concerns, proponents of residential treatment require economic evidence to justify further investments in this modality over less intensive and less costly options. Recent studies have developed methods and empirical guidelines for using the drug abuse treatment cost analysis program (DATCAP) and the addiction severity index (ASI) in a comprehensive economic evaluation of addiction treatment. The present study applied these methods and guidelines to estimate the economic costs and benefits of residential addiction treatment at five programs in the State of Washington, USA that serve publicly funded clients. Program- and client-specific economic cost estimates were derived using data collected on-site with the DATCAP along with opportunity cost estimates associated with treatment attendance. Economic benefits were calculated from client self-reported information at treatment entry and at 6 months post discharge using the ASI. Outcome categories included inpatient services, employment, medical and psychiatric conditions, and criminal activity. Results indicate that average weekly economic cost of treatment services at the five programs ranged from $463 to $703. Average (per client) economic cost of treatment was $4912 (composed of $3650 in program cost and $1262 in client cost) for all subjects that completed both a baseline and follow-up questionnaire (N = 222; 82%). Average (per client) total economic benefit was $21,329, leading to estimates of $16,418 for average net benefit and 4.34 for the benefit-cost ratio. Total and net economic benefits were significantly related to gender, race, religious preference, and baseline ASI composite scores for drug use and legal status. A detailed sensitivity analysis did not alter the qualitative findings. This study provides conclusive evidence that, for this sample of programs in Washington State, the economic benefits of residential addiction treatment significantly exceeded the economic costs. Although the results are not necessarily generalizable to private-paying clients or clients from other States in the US, the methods are based on widely used data collection instruments and well-accepted economic principles. Thus, extensions of this research to other clients, States, and modalities should be feasible and straightforward. (C) 2002 Elsevier Science Ltd. All rights reserved.