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成瘾治疗的效益成本分析:使用药物滥用治疗成本效益分析量表(DATCAP)和成瘾严重程度指数(ASI)的方法指南及实证应用

Benefit-cost analysis of addiction treatment: methodological guidelines and empirical application using the DATCAP and ASI.

作者信息

French Michael T, Salomé Helena J, Sindelar Jody L, McLellan A Thomas

机构信息

Department of Economics, Pompeu Fabra University, Barcelona, Spain.

出版信息

Health Serv Res. 2002 Apr;37(2):433-55. doi: 10.1111/1475-6773.031.

Abstract

OBJECTIVE

To provide detailed methodological guidelines for using the Drug Abuse Treatment Cost Analysis Program (DATCAP) and Addiction Severity Index (ASI) in a benefit-cost analysis of addiction treatment.

DATA SOURCES/STUDY SETTING: A representative benefit-cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines.

STUDY DESIGN

Procedures are outlined for using resource use and cost data collected with the DATCAP. Techniques are described for converting outcome measures from the ASI to economic (dollar) benefits of treatment. Finally, principles are advanced for conducting a benefit-cost analysis and a sensitivity analysis of the estimates.

DATA COLLECTION/EXTRACTION METHODS: The DATCAP was administered at three outpatient drug-free programs in Philadelphia, PA, for 2 consecutive fiscal years (1996 and 1997). The ASI was administered to a sample of 178 treatment clients at treatment entry and at 7-months postadmission.

PRINCIPAL FINDINGS

The DATCAP and ASI appear to have significant potential for contributing to an economic evaluation of addiction treatment. The benefit-cost analysis and subsequent sensitivity analysis all showed that total economic benefit was greater than total economic cost at the three outpatient programs, but this representative application is meant to stimulate future economic research rather than justifying treatment per se.

CONCLUSIONS

This study used previously validated, research-proven instruments and methods to perform a practical benefit-cost analysis of real-world treatment programs. The study demonstrates one way to combine economic and clinical data and offers a methodological foundation for future economic evaluations of addiction treatment.

摘要

目的

为在成瘾治疗的效益成本分析中使用药物滥用治疗成本分析程序(DATCAP)和成瘾严重程度指数(ASI)提供详细的方法指南。

数据来源/研究背景:对三个门诊项目进行了具有代表性的效益成本分析,以证明方法指南的可行性和价值。

研究设计

概述了使用通过DATCAP收集的资源使用和成本数据的程序。描述了将ASI的结果指标转换为治疗的经济(美元)效益的技术。最后,提出了进行效益成本分析和估计值敏感性分析的原则。

数据收集/提取方法:在宾夕法尼亚州费城的三个门诊戒毒项目中连续两个财政年度(1996年和1997年)实施DATCAP。在治疗开始时和入院后7个月,对178名治疗客户的样本实施ASI。

主要发现

DATCAP和ASI在成瘾治疗的经济评估方面似乎具有巨大潜力。效益成本分析及随后的敏感性分析均表明,这三个门诊项目的总经济效益大于总经济成本,但这种具有代表性的应用旨在推动未来的经济研究,而非证明治疗本身的合理性。

结论

本研究使用了先前经过验证、经研究证实的工具和方法,对实际治疗项目进行了实用的效益成本分析。该研究展示了一种整合经济和临床数据的方法,并为未来成瘾治疗的经济评估提供了方法基础。

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