Benefit‐Cost Methodology in the Evaluation of Therapeutic Services for Alcoholism

Rundell, O. H.; Paredes, Alfonso

doi:10.1111/j.1530-0277.1979.tb05331.x

Cited by 16 publications

(3 citation statements)

References 15 publications

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“…Though none of the clinical trials directly addressed cost, brief alcohol intervention compared with all other available alcohol intervention programs has been shown to be the least expensive. 126,127 Holder and coworkers estimate that the expense of brief alcohol intervention is somewhat less than $100. 126 In regard to mortality and morbidity rates, drinking moderation and problem-free drinking tend to lead to a decrease in alcohol-related disease and improved health and wellbeing.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of Randomized Control Trials Addressing Brief Interventions in Heavy Alcohol Drinkers

1997

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OBJECTIVE:To assess the effectiveness of brief interventions in heavy drinkers by analyzing the outcome data and methodologic quality. DESIGN:(1) Qualitative analysis of randomized control trials (RCTs) using criteria from Chalmers' scoring system; (2) calculating and combining odds ratios (ORs) of RCTs using the One-Step (Peto) and the Mantel-Haenszel methods. STUDY SELECTION AND DATA ANALYSIS: A MEDLINE andPsycLIT search identified RCTs testing brief interventions in heavy alcohol drinkers. Brief interventions were less than 1 hour and incorporated simple motivational counseling techniques much like outpatient smoking cessation programs. By a single-reviewer, nonblinded format, eligible studies were selected for adult subjects, sample sizes greater than 30, a randomized control design, and incorporation of brief alcohol interventions. Methodologic quality was assessed using an established scoring system developed by Chalmers and colleagues. Outcome data were combined by the One-Step (Peto) method; confidence limits and 2 test for heterogeneity were calculated. RESULTS:Twelve RCTs met all inclusion criteria, with an average quality score of 0.49 ؎ 0.17. This was comparable to published average scores in other areas of research (0.42 ؎ 0.16). Outcome data from RCTs were pooled, and a combined OR was close to 2 (1.91; 95% confidence interval 1.61-2.27) in favor of brief alcohol interventions over no intervention. This was consistent across gender, intensity of intervention, type of clinical setting, and higher-quality clinical trials. CONCLUSIONS:Heavy drinkers who received a brief intervention were twice as likely to moderate their drinking 6 to 12 months after an intervention when compared with heavy drinkers who received no intervention. Brief intervention is a low-cost, effective preventive measure for heavy drinkers in outpatient settings. significant number of North Americans drink excessive amounts of alcohol. Although excessive alcohol use is often socially accepted behavior, there is a notable increased risk of workforce dysfunction, motor vehicle accidents, injuries, marital discord, family dysfunction, alcoholrelated disease, and death. 1 Average daily alcohol consumption above two or three drinks has been shown to result in subjective complaints, physical findings, alcoholrelated problems, and alcohol dependence. 2,3 These consequences of excessive alcohol use are seen in the primary care and hospital settings with prevalence rates approaching 20% to 40%. [4][5][6][7][8] Excessive drinking behavior, often described as problem drinking, heavy drinking, or at-risk drinking, is generally not associated with alcohol dependence such as major withdrawal symptoms, tolerance, complete loss of control, or preoccupation with drinking. 9 The definition of excessive or problem drinking is imprecise and often depends on not only quantity and frequency of alcohol consumed but also individual characteristics such as gender, age, weight, and comorbid conditions. 10 The Institute of Medicine reports that up to 20% of ...

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of Randomized Control Trials Addressing Brief Interventions in Heavy Alcohol Drinkers

1997

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“…The difference between cost-effectiveness analysis and benefit-cost analysis is fundamental. Benefit-cost analysis may be preferred to cost-effectiveness analysis when diverse outcomes of the treatment intervention need to be included and programs with different goals or effects must be compared (Rundell and Paredes 1979;Swint and Nelson 1977;Sindelar et al 1999).…”

Section: Background Economic Evaluation Methodsmentioning

confidence: 99%

Benefit-Cost Analysis of Residential and Outpatient Addiction Treatment in the State of Washington

et al. 2000

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A benefit-cost analysis of full continuum (FC) and partial continuum (PC) care was conducted on a sample of substance abusers from the State of Washington. Economic benefits were derived from client self-reported information at treatment entry and at 9 months postadmission using an augmented version of the Addiction Severity Index (ASI). Average (i.e., per client) economic benefits of treatment from baseline to follow-up for both FC and PC were statistically significant for most variables and in the aggregate. The overall difference in average economic benefit between FC and PC was positive ($8,053) and statistically significant, favoring FC over PC. The average cost of treatment amounted to $2,530 for FC and $1,138 for PC (p < .01). Average net benefits were estimated to be $17,833 (9.70) for FC and $11,173 (23.33) for PC, with values showing statistical significance (p < .05). Results strongly indicate that both treatment options generated positive and significant net benefits to society.

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“…The differences between cost-effectiveness analysis and benefit-cost analysis are fundamental. Benefit-cost analysis may be preferred to costeffectiveness analysis when diverse outcomes of the treatment intervention need to be included and programs with different goals or effects must be compared (Rundell and Paredes 1979;Sindelar and Manning 1997;Swint and Nelson 1977). Furthermore, benefit-cost analysis may be more appropriate when outcomes beyond those of the patients' perspective need to be quantified (Drummond et al 1997).…”

Section: Background Overview Of Economic Evaluationsmentioning

confidence: 99%

Outpatient Marijuana Treatment for Adolescents

et al. 2003

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An economic evaluation of five outpatient adolescent treatment approaches (12 total site-by-conditions) was conducted. The economic cost of each of the 12 site-specific treatment conditions was determined by the Drug Abuse Treatment Cost Analysis Program (DATCAP). Economic benefits of treatment were estimated by first monetizing a series of treatment outcomes and then analyzing the magnitude of these monetized outcomes from baseline through the 12-month follow-up. The average economic costs ranged from $90 to $313 per week and from $839 to $3,279 per episode. Relative to the quarter before intake, the average quarterly cost to society for the next 12 months (including treatment costs) significantly declined in 4 of the 12 site-by-treatment conditions, remained unchanged in 6 conditions, and increased in 2 treatment conditions (both in the same site). These results suggest that some types of substance-abuse intervention for adolescents can reduce social costs immediately after treatment.

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Benefit‐Cost Methodology in the Evaluation of Therapeutic Services for Alcoholism

Cited by 16 publications

References 15 publications

Meta-analysis of Randomized Control Trials Addressing Brief Interventions in Heavy Alcohol Drinkers

Meta-analysis of Randomized Control Trials Addressing Brief Interventions in Heavy Alcohol Drinkers

Benefit-Cost Analysis of Residential and Outpatient Addiction Treatment in the State of Washington

Outpatient Marijuana Treatment for Adolescents

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