COST EFFECTIVENESS OF PERINATAL SUBSTANCE ABUSE PROGRAMS

怀孕期间滥用药物预计会带来高昂的长期成本 向社会致敬。这些成本的大小尚未完全量化。 拟议研究的目标是确定和量化更广泛的 费用范围，并评估替代治疗的程度 有效地降低了这些成本。对成本效益过高的批评 研究表明，它只对那些 选择该计划，但不表明该计划是否有效 适用于其他人群。这项研究建立在正在进行的随机调查的基础上 审判，以减少自我选择的问题。我们的初步研究 人口包括参加母亲项目的妇女，该项目由 华盛顿州酒精和药物滥用部门。女人是 随机分成三种类型的强化治疗门诊；短期 住院加重症门诊患者为对照组， 包括在其他社区项目中进行治疗。其他比较 群体包括(1)被确认为化学依赖的孕妇 在通过CSAP名为出生到3岁的项目交付时，没有收到 孕期物质滥用治疗；及(2)孕期物质 通过其他公费治疗接受治疗的施虐者 程序。对于每个组，我们将确定其数量和成本 在怀孕期间接受的不同服务在三年后 分娩期。由国家维护的二级数据库将确定结果 以及与使用收入援助、医疗援助、 心理健康服务、儿童保护服务、寄养、就业 历史和重罪定罪，以及其他。我们将比较 母亲的治疗和其他项目的产前费用，包括产后 确定与替代方案相关的公共成本节约的成本 治疗方式。对于特定的结果，我们将使用多变量 确定治疗效果的回归技术 不同医疗模式的特征。替代方案的成本效益 然后，针对预期结果的治疗组件将被 下定决心。拟议的研究将对以下方面作出重大贡献： 关于药物滥用的成本效益和成本效益的文献 量化公众对化学依赖孕妇的治疗 与替代产前治疗模式相关的成本节约， 以及确定哪些服务在生产所需的 结果。

Substance abuse during pregnancy is expected to have a high long-term cost to society. The magnitude of those costs have yet to be fully quantified. The goal of the proposed research is to identify and quantify a wider range of costs and assess the extent to which alternative treatments are effective in reducing those costs. Criticism of much cost-effectiveness research has been that it demonstrates effectiveness only for those who choose that program, but does not indicate whether it could be effectively applied to other populations. This study builds on an ongoing randomized trial in order to reduce the problem of self-selection. Our primary study population includes women enrolled in the MOM'S project, operated by the Washington State Division of Alcohol and Substance Abuse. Women are randomized into three types of treatment intensive outpatient; short term residential combined with intensive outpatient; and a control group which consists of treatment in other community programs. Additional comparison groups include (1) chemically dependent pregnant women who are identified at delivery through a CSAP project entitled Birth to 3, having received no substance abuse treatment during pregnancy; and (2) pregnant substance abusers who receive treatment through other publicly-funded treatment programs. For each of these groups we will identify the number and cost of different services received during pregnancy through three years post- partum. Secondary databases maintained by the state will identify outcomes and costs associated with use of income assistance, medical assistance, mental health services, child protective services, foster care, employment history, and felony convictions, among others. We will compare the prenatal cost of MOM'S treatment and other programs, with post-partum costs to determine public cost-savings associated with alternative treatment modalities. For specific outcomes we will use multivariate regression techniques to determine the effectiveness of treatment characteristics across modalities. The cost-effectiveness of alternative treatment components with respect to the desired outcome will then be determined. The proposed study will make a substantial contribution to the literature on cost-benefit and cost-effectiveness of substance abuse treatment of chemically dependent pregnant women by quantifying public cost-savings associated with alternative prenatal treatment modalities, and identifying which services are cost-effective at producing the desired outcomes.