Three Methods for Costing Methadone Treatment Services

描述(由申请人提供)： 管理式医疗和政府支出的削减给提供者、付款人和研究人员带来了巨大的压力，要求他们证明药物治疗服务的成本效益和成本效益。作为这些经济评估的第一步，必须估计具体治疗服务的成本。虽然以前的许多工作都估算了药物治疗成本，但服务成本估算的数量非常有限，而且还没有研究评估替代数据收集方法对估算服务成本的影响。此外，以前没有任何工作试图估计收集服务成本数据的负担。我们建议的分析评估了美沙酮治疗计划中估算服务水平成本的三种替代方法。这三种方法的不同之处在于它们如何收集治疗服务中工作人员的时间分配。三种可供选择的数据收集方法是：(1)调查诊所主任(关键信息者)；(2)调查诊所工作人员(工作人员信息者)；(3)为期1周的工作人员日记。我们的分析将评估用于收集各替代治疗服务的工作人员时间分配的方法的差异在多大程度上导致服务费用估计数的差异。此外，作为服务成本评估的一部分，我们还将估计收集三种数据收集方法的工作人员时间分配数据的成本。这三种评估方法的实施将在美沙酮诊所的样本中进行，这些诊所是CSAT评估美沙酮/LAAM治疗认可项目的一部分。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，(2)估计特定治疗服务的成本，以及(3)评估服务成本差异的来源。研究团队在估计治疗成本方面有很好的记录，对这项研究涉及的基本问题有广泛的知识和洞察力。在我们建议的研究项目结束时，我们将了解收集工作人员劳动时间的差异对治疗服务成本估计的影响程度，我们将制定并实施适用于所有药物治疗模式的修订后的服务成本估计方法。

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.