Benefit-cost analysis of a modified therapeutic community for mentally ill chemical abusers
Benefit-cost analysis of a modified therapeutic community for mentally ill chemical abusers
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DOI：
10.1016/s0149-7189(02)00006-x
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发表时间：
2002-05-01
影响因子：
1.6
通讯作者：
De Leon, G
中科院分区：
文献类型：
--
作者：
French, MT;McCollister, KE;De Leon, G
本文估计和比较的经济效益和成本的修改治疗社区（修改TC）治疗无家可归的精神疾病化学品滥用者（MICA）相对于“照常治疗”（TAU）的对照组。将入院前12个月的数据与入院后12个月的数据进行比较，这三个结果类别是：就业、犯罪活动和医疗保健服务的利用。平均改良TC治疗事件的经济成本为20，361美元。经修改的TC客户平均产生的经济效益为305，273美元。每个修改后的TC客户的增量经济效益（相对于TAU）为273，698美元，导致每个修改后的TC客户的净效益为253，337美元，效益成本比为13：1。调整极端离群值观察，增量经济效益估计为105，618美元，净效益为85，257美元，效益成本比为5.2。这些结果量化了修改后的TC方法的潜在经济和社会优势，并强调了修改后的TC计划对无家可归者MICA的政策影响。这项研究是对无家可归者MICA的TC治疗的第一次全面经济评估;未来的研究可以借鉴这里概述的经济分析方法，以适用于更大的样本，更长的随访期和其他治疗环境。(C)2002爱思唯尔科技有限公司。保留所有权利。
This paper estimates and compares the economic benefits and costs of modified therapeutic community (modified TC) treatment for homeless mentally ill chemical abusers (MICAs) relative to a 'treatment-as-usual' (TAU) comparison group. Data from the period 12 months pre-admission to the modified TC were compared to data from 12 months post-admission across three outcome categories: employment, criminal activity, and utilization of health care services. The economic cost of the average modified TC treatment episode was $20,361. The economic benefit generated by the average modified TC client was $305,273. The incremental economic benefit per modified TC client (relative to TAU) was $273,698, resulting in a net benefit per modified TC client of $253,337 and a benefit-cost ratio of 13:1. Adjusting for extreme outlier observations, the incremental economic benefit estimate was $105,618, net benefit was $85,257, and the benefit-cost ratio was 5.2. These results quantify the potential economic and social advantages of the modified TC approach and highlight the policy implications of modified TC programs for homeless MICAs. This study is the first comprehensive economic evaluation of TC treatment for homeless MICAs; future research can draw from the economic analysis methods outlined here to apply to larger samples, longer follow-up periods, and other treatment settings. (C) 2002 Elsevier Science Ltd. All rights reserved.