Department of Community Health and Sustainability, School of Health and Environment, University of Massachusetts Lowell, 300 Weed Hall, 3 Solomont Way Lowell, MA 01854, USA.
Subst Abuse Treat Prev Policy. 2010 Jul 5;5:14. doi: 10.1186/1747-597X-5-14.
This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families) was too small to be economical. Although the sample size (just nine programs) was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's) Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW) Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.
本简短报告探讨了家庭药物滥用治疗计划中的规模效应。在马萨诸塞州，家庭药物滥用治疗计划比其他成人住院治疗模式的成本高得多。州政府官员担心这些计划的“规模”（平均只有 8 个家庭）太小，不经济。尽管样本量（只有 9 个计划）太小，无法进行可靠的推断，但数据清楚地表明了“规模效应”在这些家庭药物滥用治疗计划中的重要性。为了进一步研究家庭药物滥用治疗计划中的规模效应，对药物滥用治疗中心 (CSAT) 的住宅妇女和儿童以及孕妇和产后妇女 (RWC-PPW) 示范项目的数据进行了重新分析，重点关注成本/每户天数与估计的平均家庭人口普查之间的关系。这一分析表明，在平均家庭人口普查达到约 14 之前，存在很强的规模经济效应，而在此之后，规模效应则不那么明显。考虑到这些和其他研究结果，一个多学科机构间团队重新设计了马萨诸塞州的家庭治疗计划模式。新计划比以前的家庭治疗计划更大，每个新计划都有能力根据家庭构成治疗 11 到 15 个家庭。
