The RAND Alcohol Policy Platform (RAPP): A Microsimulation Model of Alcohol Use, Consequences, and Policies in the United States

说明：在国家和国际两级，酒精消费对健康和社会造成的负担越来越大，这有助于提高人们对有效的酒精管制政策的认识和兴趣。在美国，每年约有8万人死于饮酒。仅医疗保健成本就估计为256亿美元，其中过度饮酒的全部社会成本超过2200亿美元。在全球层面上，饮酒是健康状况不佳的第三大风险因素，2004年占全球所有死亡人数的4%。在15岁至29岁的年轻人中，十分之九的死亡是由酒精相关的原因造成的。然而，相对缺乏有充分根据的全面分析工具，往往使国家和国际政策机构无法全面考虑不同政策行动的成本和后果。在这个为期5年的项目中，我们建议建立一个综合决策支持平台，用于在国家司法管辖区内和跨国家司法管辖区对替代酒精政策的健康、社会和经济影响进行评估。这个项目的具体目标是：(1)开发、测试和验证一个动态微观模拟建模平台，捕获美国和其他六个相关中高收入国家的酒精使用的个人和社会动态；(2)利用该平台预测与当前酒精使用模式相关的健康、社会和经济后果；以及(3)评估三项酒精控制政策(定价政策、血液酒精浓度水平和治疗)在减少与酒精滥用相关的社会危害方面的结果和成本。我们的模型将跟踪每个人每杯酒的饮酒量，并捕捉美国和其他六个国家的关键疾病和健康结果、医疗服务利用和成本以及对生产率的影响，从而使该模型能够考虑政策和社会结构之间的重要互动。重要的是，提出了一种新的估计过程，该过程将严格量化参数不确定性对结果的影响。模型估计的这一改进将使预防和治疗战略的影响能够得到更有效的评估，并有可能影响社会政策建模领域。将纳入该平台的国家包括：加拿大、智利、芬兰、墨西哥、俄罗斯联邦、英国和美国。我们的国际可比平台将使美国政策制定者和研究人员能够为美国评估其他地方实施的酒精政策的影响：包括更高的酒精税和更负担得起的治疗。

DESCRIPTION: The growing burden of alcohol consumption on health and society at both the national and the international level have contributed to the raising awareness and interest in effective alcohol control policy. In the United States (U.S.), there are approximately 80,000 deaths each year attributed to alcohol use. Healthcare costs alone are estimated at $25.6 billion, with the full societal cost of excessive drinking exceeding $220 billion. At the global leel, alcohol use is the third leading risk factor for poor health and was the cause of 4% of all deaths worldwide in 2004. Among young people between the ages of 15 and 29, nine in ten deaths are due to alcohol-related causes. However, the relative scarcity of well-grounded and comprehensive analytic tools often prevents national and international policy bodies from considering the full range of costs and consequences of different policy actions. In this 5 year project, we propose to build an integrated decision-support platform that can be used to conduct evaluations of the health, social and economic impacts of alternative alcohol policies within and across national jurisdictions. The specific aims of this project are to do the following: (1) Develop, test and validate a dynamic micro simulation modeling platform, capturing both individual and social dynamics of alcohol use for the U.S. and a selection of six other relevant high- and middle-income countries; (2) Use the platform to project the health, social and economic consequences associated with current alcohol-use patterns; and (3) Assess the outcomes and costs of three alcohol control policies (pricing policies, blood alcohol concentration levels, and treatment) at reducing the social harms associated with alcohol misuse. Our model will track individuals' alcohol consumption on a per drink basis and capture key diseases and health outcomes, health service utilization and costs, and productivity impacts across the U.S. and six other countries, thereby enabling the model to consider important interactions between policy and social structures. Importantly, a novel estimation process is proposed that will rigorously quantify the effect of parameter uncertainty on results. This improvement in model estimation will enable more effective evaluation of the impacts of prevention and treatment strategies and has the potential to influence the social-policy modeling field. Countries to be included in the platform are: Canada, Chile, Finland, Mexico, the Russian Federation, the United Kingdom and the United States. Our internationally comparable platform will enable U.S. policy makers and researchers to evaluate, for the U.S., the impact of alcohol policies implemented elsewhere: including higher alcohol taxes and more affordable treatment.