Three Methods for Costing Methadone Treatment Services

描述（由申请人提供）： 管理式医疗和政府开支的减少给提供者、支付者和研究人员带来了巨大的压力，他们必须证明药物治疗服务的成本效益和成本效益。作为这些经济评价的第一步，必须估计具体治疗服务的费用。虽然以前的许多工作估计药物治疗费用，只有非常有限的服务成本估计数存在，没有研究评估替代数据收集方法对估计服务成本的影响。此外，没有以前的工作试图估计收集服务成本数据的负担。我们提出的分析评估三种替代方法估计美沙酮治疗计划的服务水平成本。这三种方法的不同之处在于它们如何收集工作人员在治疗服务中的时间分配。三种替代数据收集方法是（1）调查诊所主任（关键知情人），（2）调查诊所工作人员（工作人员知情人），（3）工作人员日记1周。我们的分析将评估在何种程度上的差异，用于收集工作人员的时间分配在替代治疗服务的服务成本估计的差异。此外，作为服务成本评估的一部分，我们还将估计三种数据收集方法中每种方法收集员工时间分配数据的成本。这三种估计方法的实施将发生在美沙酮诊所的样本，是CSAT的美沙酮/LAAM治疗认证项目的评估的一部分。为了实现我们的研究目标，我们分析的具体目标是：（1）制定美沙酮治疗服务和工作类型的修订分类法，（2）估计特定治疗服务的成本，以及（3）评估服务成本变化的来源。该研究团队在估计治疗费用方面有着良好的记录，并对本研究所涉及的基本问题有着广泛的知识和见解。在我们提出的研究项目的结论，我们将了解在何种程度上收集工作人员劳动时间的差异影响治疗服务成本的估计，我们将制定和实施一个修订的服务成本估计方法，将适用于所有药物治疗方式。

DESCRIPTION (provided by applicant): Managed care and reductions in government spending have placed great pressure on providers, payers, and researchers to demonstrate the cost-effectiveness and cost-benefits of drug treatment services. As a first step in these economic evaluations, the costs of specific treatment services must be estimated. Although much previous work has estimated drug treatment costs, only a very limited number of service cost estimates exist, and no study has evaluated the effect of alternative data collection methods on estimated service costs. Furthermore, no previous work has attempted to estimate the burden of collecting service cost data. Our proposed analysis evaluates three alternative methods for estimating service-level costs in methadone treatment programs. These three methods differ in how they collect staff time allocation across treatment services. The three alternative data collection methods are (1) surveying the clinic director (key informant), (2) surveying the clinic staff (staff informants), and (3) staff diaries for 1 week. Our analysis will assess the extent to which differences in the method used to collect the staff time allocation across alternative treatment services contribute to differences in service cost estimates. In addition, as part of the service cost evaluation, we will also estimate the costs of collecting the staff time allocation data for each of the three data collection methods. Implementation of these three estimation methods will occur in a sample of methadone clinics that were part of CSAT's Evaluation of the Methadone/LAAM Treatment Accreditation Project. To accomplish our research objectives, the specific aims of our analysis are to (1) develop a revised taxonomy of methadone treatment services and job types, (2) estimate the costs of specific treatment services, and (3) evaluate the sources of service cost variation. The research team has a strong track record estimating the costs of treatment, and extensive knowledge and insights into the fundamental issues involved in this research. At the conclusion of our proposed research project, we will understand the extent to which differences in collecting staff labor time affect estimates of treatment service cost, and we will have developed and implemented a revised service cost estimation methodology that will be applicable to all drug treatment modalities.