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与互助社区康复之家相关的收益与成本:牛津之家模式。

Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model.

作者信息

Lo Sasso Anthony T, Byro Erik, Jason Leonard A, Ferrari Joseph R, Olson Bradley

机构信息

Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60660, USA.

出版信息

Eval Program Plann. 2012 Feb;35(1):47-53. doi: 10.1016/j.evalprogplan.2011.06.006. Epub 2011 Jul 22.

Abstract

We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost-benefit analysis of the program. Following substance abuse treatment, individuals that were assigned to an OH condition (n=68) were compared to individuals assigned to a usual care condition (n=61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration. Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant. Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs. The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.

摘要

我们使用了一项关于牛津之家(OH)的随机对照研究的数据,牛津之家是一个自主经营、自给自足的康复之家,对该项目进行成本效益分析。在药物滥用治疗之后,将被分配到牛津之家条件组(n = 68)的个体与被分配到常规护理条件组(n = 61)的个体进行比较。经济成本衡量指标来自于在牛津之家居住的时长,以及来自于自我报告的住院和门诊治疗利用情况的指标。经济效益衡量指标来自于自我报告的月收入信息、参与非法活动的天数、酒精和药物使用的二元反应以及监禁情况。结果表明,牛津之家与常规护理相比相当有利:在牛津之家停留的净收益估计平均每人约为29,000美元。自抽样法标准误差表明净收益具有统计学显著性。在牛津之家模式下成本有所增加,但在减少非法活动、监禁和药物使用方面的收益大大超过了成本。牛津之家的正净收益主要是由牛津之家参与者和常规护理参与者在非法活动方面的巨大差异所驱动。通过敏感性分析,在更保守的假设下,我们仍然得出对牛津之家有利的净收益为每人17,830美元。

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