COST EFFECTIVENESS OF PERINATAL SUBSTANCE ABUSE PROGRAMS

怀孕期间滥用药物预计将产生很高的长期成本 对社会的贡献这些费用的数额尚待充分量化。 拟议研究的目标是确定和量化更广泛的 成本范围，并评估替代治疗的程度 有效降低这些成本。对成本效益过高的批评 研究表明，它只对那些 选择该计划，但没有表明它是否可以有效地 适用于其他人群。这项研究建立在正在进行的随机 以减少自我选择的问题。我们的主要研究 人口中包括参加由联合国难民事务高级专员办事处（难民署） 华盛顿州酒精和药物滥用部门。妇女 随机分为三种类型的治疗强化门诊;短期 住院与重症门诊相结合;对照组， 包括其他社区项目的治疗。额外比较 这些群体包括：（1）被确定为具有化学依赖性的孕妇， 在通过题为“从出生到3岁”的加拿大社会援助方案项目分娩时， 怀孕期间的物质滥用治疗;（2）怀孕物质 透过其他公帑资助的治疗方法接受治疗的滥用药物者 程序.对于每一组，我们将确定 在怀孕期间至产后三年期间接受的不同服务 分娩的时候。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 历史和重罪定罪等等我们将比较 产前费用的治疗和其他方案，与产后 确定与替代方案有关的公共成本节约的费用 治疗方式。 对于特定的结果，我们将使用多变量 回归技术，以确定治疗的有效性 跨模态的特性。 替代品的成本效益 然后，针对期望结果的治疗组分将被 测定 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 通过量化公众对药物依赖性孕妇的 与替代性产前治疗方式相关的成本节约， 并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.