Cost of Screening, Brief Intervention, and Referral to Treatment in Health Care Settings
Cost of Screening, Brief Intervention, and Referral to Treatment in Health Care Settings
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DOI：
10.1016/j.jsat.2015.06.005
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发表时间：
2016-01-01
影响因子：
3.9
通讯作者：
Bray, Jeremy W.
中科院分区：
文献类型：
--
作者：
Barbosa, Carolina;Cowell, Alexander J.;Bray, Jeremy W.
目的：本研究分析了美国三个州和一个部落组织在急诊科（ED）、住院和门诊医疗机构实施的药物滥用筛查、短暂干预和转诊治疗（SBIRT）项目的服务单位和年度成本。方法：从服务提供者的角度估算单位成本和年成本。单位成本数据来自26个演出场地，年成本数据来自10个项目。采用自底向上的方法得出单位成本，包括每个SBIRT活动中使用的人工、空间和材料。活动包括直接的SBIRT服务和支持直接服务交付的活动。每项活动花费的劳动时间由训练有素的观察员使用时间-动作方法收集。自上而下的方法使用由项目管理员完成的成本调查问卷来计算年度成本，包括劳动力、空间、合同服务、管理费用、培训、旅行、设备、供应和材料。费用按2012年的美元计算。结果：ED的预筛查、筛查、简短干预、简短治疗和转介治疗的平均单位成本分别为0.61美元、6.59美元、10.48美元、22.63美元和12.06美元；住院费用分别为0.86美元、6.33美元、9.07美元、27.61美元和8.03美元；门诊分别为0.84美元、3.98美元、7.81美元、27.94美元和9.23美元；一半以上的费用可归因于支助活动。在所有情况下，1年内每个阳性筛检提供SBIRT的平均成本约为400美元。结论：支助活动占费用的很大一部分。健康管理人员可以使用结果来预算，并比较为SBIRT报销的站点数量与服务的实际成本。(C) 2015爱思唯尔公司版权所有。
Aims: This study analyzed service unit and annual costs of substance abuse screening, brief intervention, and referral to treatment (SBIRT) programs implemented in emergency department (ED), inpatient, and outpatient medical settings in three U.S. states and one tribal organization.Methods: Unit costs and annual costs were estimated from the perspective of service providers. Data for unit costs came from 26 performance sites, and data for annual costs came from 10 programs. A bottom-up approach was used to derive unit costs and included labor, space, and materials used in each SBIRT activity. Activities included direct SBIRT services and activities that support direct service delivery. Labor time spent in each activity-was collected by trained observers using a time-and-motion approach. A top-down approach used cost questionnaires completed by program administrators to calculate annual costs and included labor, space, contracted services, overhead, training, travel, equipment, and supplies and materials. Costs were estimated in 2012 U.S. dollars.Results: Average unit costs for prescreening, screening, brief intervention, brief treatment, and referral to treatment were $0.61, $6.59, $10.48, $22.63, and $12.06 in ED; $0.86, $6.33, $9.07, $27.61, and $8.03 in inpatient; and $0.84, $3.98, $7.81, $27.94, and $9.23 in outpatient settings, respectively; over half of the costs were attributable to support activities. Across all settings, the average cost to provide SBIRT per positive screen, for 1 year, was about $400.Conclusions: Support activities comprise a large proportion of costs. Health administrators can use the results to budget and compare how much sites are reimbursed for SBIRT to how much services actually cost. (C) 2015 Elsevier Inc. All rights reserved.