Skip to main content
SpringerLink
Log in

Economic Evaluation of Alcohol Treatment Services

  • Chapter
Alcoholism

Part of the book series: Recent Developments in Alcoholism ((RDIA,volume 15))

Abstract

The objective of this paper is to summarize and critically review the most recent literature on economic evaluation of alcohol treatment services, identify information gaps, and suggest a research agenda for the future. The focus of the review is research published after 1995, although some of the earlier economic studies are also included. Research findings in the literature provide evidence for the following. First, for many alcoholics, day hospital treatment or even less intensive outpatient services are cost-effective alternatives to inpatient treatment. Second, alcoholism treatment often results in declining health care costs for alcoholics who are covered by private health insurance. Third, though the use of alcoholics anonymous (AA) as an alternative to more structured alcohol treatment services may be cost-effective, substance abuse outcomes from AA are sometimes less favorable and the risk of relapse is higher. Fourth, methods have recently been developed to estimate the dollar value of alcohol tr eatment outcomes such as avoided absenteeism, increased productivity, improved health, and avoided crime. Based on these findings and developments, new treatment approaches and changes in service delivery systems require a fresh perspective on the costs and benefits of alternative treatment services. The findings from economic evaluation studies must be reported in clear and nontechnical terms to an audience of clinicians and politicians so that they can be used in the process of decision making.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Drummond MJ, O’Brien BJ, Stoddart GL, Torrance GW (1997) Methods for the Economic Evaluation of Health Care Programmes, 2nd ed. New York. Oxford University Press, 1997.

    Google Scholar 

  2. Sindelar JL, Manning Jr WG: Cost-benefit and cost-effectiveness analysis: Issues in the evaluation of the treatment of illicit drug abuse, in Egertson JA, Fox DM, Leshner AI (eds): Treating Drug Abusers Effectively. Malden, MA, Blackwell Publishers, 1997.

    Google Scholar 

  3. Gold MR, Russell LB, Siegel J, Weinstein MC: Cost-effectiveness in Health and Medicine. New York, Oxford University Press, 1996.

    Google Scholar 

  4. French MT Economic evaluation of drug abuse treatment programs: Methodology and findings. Am J Drug Alcohol Abuse 21:111–135, 1995.

    Article  PubMed  Google Scholar 

  5. Holder HD: Alcoholism treatment and potential health care cost saving. Med Care 25:52–71,1987.

    Article  PubMed  Google Scholar 

  6. Holder HD, Longabaugh R, Miller WR, Rubonis AV The Cost-effectiveness of treatment for alcoholism: A first approximation. J Stud Alcohol 52:517–540, 1991.

    PubMed  Google Scholar 

  7. Siegel, JE, Weinstein, MC, Russell, LB, Gold, MR, for the Panel on Cost-Effectiveness in Health and Medicine: Recommendations for reporting cost-effectiveness analyses. JAMA 276:1339–1341, 1996.

    Article  PubMed  Google Scholar 

  8. Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC, for the Panel on Cost-Effectiveness in Health and Medicine: The role of cost-effectiveness analysis in health and medicine. JAMA 276:1172–1177, 1996.

    Article  PubMed  Google Scholar 

  9. Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB, for the Panel on Cost-Effectiveness in Health and Medicine: Recommendations of the panel on cost-effectiveness in health and medicine. JAMA 276:1253–1258, 1996.

    Article  PubMed  Google Scholar 

  10. Tolley G, Kenkel D, Fabian R: ValuingHealthforPolicy: An EconomicApproach. Chicago, The University of Chicago Press, 1994.

    Google Scholar 

  11. Sloan FA (ed): Valuing Health Care. New York, Cambridge University Press, 1996.

    Google Scholar 

  12. Hargreaves WA: Cost-Outcome Methods for Mental Health. San Diego, Academic Press, 1998.

    Google Scholar 

  13. Alterman AI, O’Brien CP, McLellan, AT, August, DS, Snider, EC, Droba, M, Cornish, JW, Hall, CP Raphelson, AH, and Schrade, FX: Effectiveness and costs of inpatient versus day hospital cocaine rehabilitation. JNerv Ment Dis 182:157–163,1994.

    Article  Google Scholar 

  14. Annis, HM: Is inpatient rehabilitation of the alcoholic cost-effective? Con position, Controversies in Alcoholism and Substance Abuse. Binghamton, NY The Haworth Press, Inc., pp 175–190, 1986.

    Google Scholar 

  15. Longabaugh R, McCrady B, Fink E, Stout R, McAuley T, Doyle C, McNeill, D: Cost-effectiveness of alcoholism treatment in partial vs. inpatient settings: Six-month outcomes. J Stud Alcohol 44:1049–1071, 1983.

    PubMed  Google Scholar 

  16. McCrady BS, Longabaugh R, Fink E, Stout R, Beattie M, Ruggieri-Authelet A: Cost-effectiveness of alcoholism treatment in partial hospital versus inpatient settings after brief inpatient treatment: 12-month outcomes. J Consult Clin Psychol 54:708–713, 1986.

    Article  PubMed  Google Scholar 

  17. Walsh DC, Hingson RW, Merrigan DM, Levenson SM, Cupples A, Heeren T, Coffman GA, Becker CA, Barker TA, Hamilton SK, McGuire TG, Kelly CA: A randomized trial of treatment options for alcohol-abusing workers. NEnglJMed 325:775–782, 1991.

    Google Scholar 

  18. Howard MO: Assessing the comparative cost-effectiveness of alcoholism treatments: A comment on Holder, Longabaugh, Miller and Rubonis. J Stud Alcohol 54:667–675, 1993.

    PubMed  Google Scholar 

  19. Goodman AC, Holder HD, Nishiura, E: Alcoholism treatment offset effects: A cost model. Inquiry 28:168–178, 1991.

    PubMed  Google Scholar 

  20. Holder HD, Blose, JO: Alcoholism treatment and total health care utilization and costs: A four-year longitudinal analysis of federal employees. JAMA 256:1456–1460, 1986.

    Article  PubMed  Google Scholar 

  21. Holder, HD, Blose, JO: The reduction of health care costs associated with alcoholism treatment: A 14-year longitudinal study. J Stud Alcohol 53:293–302, 1992.

    PubMed  Google Scholar 

  22. Holder HD, Blose JO: Typical patterns and cost of alcoholism treatment across a variety of populations and providers. Alcohol Clin Exp Res 15:190–195, 1991.

    Article  PubMed  Google Scholar 

  23. Jones KR, Vischi TR: Impact of alcohol, drug abuse and mental health treatment on medical care Utilization. Med Care 171, 1979.

    Google Scholar 

  24. Goodman AC, Holder HD, Nishiura E, Hankin, JR: An analysis of short-term alcoholism treatment cost functions. Med Care 30:795–810, 1992.

    Article  PubMed  Google Scholar 

  25. Heien DM, Pittman DJ: The economic costs of alcohol abuse: An assessment of current methods and estimates. J Stud Alcohol 50:567–579, 1989.

    PubMed  Google Scholar 

  26. Richman A: Cost/effectiveness analysis of alcoholism and drug abuse treatment programs: The relevance of recidivism and resource absorption. Eval Program Plann 6:49–52, 1983.

    Article  PubMed  Google Scholar 

  27. Dunlap LJ, French, MT A comparison of two methods for estimating the costs of drug abuse treatment. J Maintenance Addict 1(3):29–44, 1998.

    Article  Google Scholar 

  28. French MT, McGeary, KA: Estimating the economic cost of substance abuse treatment. Health Econ 6:539–544, 1997.

    Article  PubMed  Google Scholar 

  29. French MT, Dunlap LJ, Zarkin GA, McGeary, KA, McLellan, AT A structured instrument for estimating the economic cost of drug abuse treatment: The drug abuse treatment cost analysis program (DATCAP). JSubstAbuse Treat 14:445–455, 1997.

    Article  Google Scholar 

  30. Bray J, French MT, Bowland BJ, Dunlap LJ: The cost of employee assistance programs (EAPs): Findings from seven case studies. Employee Assist Q 11:1–19.

    Google Scholar 

  31. French MT, Dunlap L, Zarkin, GA, Karuntzos, GT: The costs of an enhanced employee assistance program (EAP) intervention. Eval Program Plann. 21:227–236, 1998.

    Article  Google Scholar 

  32. French MT, Dunlap, LJ, Galinis, DN, Rachal, JV, Zarkin, GA: Health care reforms and managed care for substance abuse services: Findings from 11 case studies. JPublic Health Policy 17:181–203, 1996.

    Article  Google Scholar 

  33. French MT, Mauskopf JA, Teague JL, Roland J: Estimating the dollar value of health outcomes from drug abuse interventions. Med Care 34:890–910,1996a.

    Article  PubMed  Google Scholar 

  34. Rajkumar AS, French MT Drug abuse, crime costs and the economic benefits of treatment. J Quant Criminol 13:291–323, 1997.

    Article  Google Scholar 

  35. Goodman AC, Nishiura E, Hankin JR, Holder HD, Tilford JM: Long-term alcoholism treatment costs. Med Care Res Rev 53: 441–464,1996.

    Article  PubMed  Google Scholar 

  36. Booth BM, Blow FC, Cook CAL, Bunn J, Fortney J: Relationship between inpatient alcoholism treatment and longitudinal changes in health care utilization. J Stud Alcohol 58:625–637, 1997.

    PubMed  Google Scholar 

  37. Barnett PG, Swindle RW Cost-effectiveness of inpatient substance abuse treatment. Health Serv Res 32:615–629, 1997.

    PubMed  Google Scholar 

  38. Finney, JW, Monahan, SC: The cost-effectiveness of treatment for alcoholism: A second approximation. J Stud Alcohol 57229–243, 1996.

    PubMed  Google Scholar 

  39. Humphreys K, Moos RH: Reduced substance-abuse-related health care costs among voluntary participants in Alcoholics Anonymous. Psychiatr Serv 47:709–713,1996.

    PubMed  Google Scholar 

  40. O’Farrell TJ, Choquette KA, Cutter HSG, Floyd FJ, Bayog R, Brown ED, Lowe J, Chan A, Deneault P: Cost-benefit and cost-effectiveness analyses of behavioral marital therapy as an addition to outpatient alcoholism treatment. J Subst Abuse 8:145–166, 1996.

    Article  Google Scholar 

  41. O’Farrell TJ, Choquette KA, Cutter HSG, Brown ED, Bayog R, McCourt W, Lowe J, Chan A, Deneault P: Cost-benefit and cost-effectiveness analyses of behavioral marital therapy with and without relapse prevention sessions for alcoholics and their spouses. Behav Ther 27:7–24, 1996b.

    Article  Google Scholar 

  42. Goodman AC, Nishiura E, Humphreys RS: Cost and usage impacts of treatment initiation: A comparison of alcoholism and drug abuse treatments. Alcohol Clin Ex. Res. 21:931–938, 1997.

    Google Scholar 

  43. Callahan, JJ, Shepard, DS, Beinecke, RH, Larson, MJ, Cavanaugh, D: Mental health/substance abuse treatment in managed care: The Massachusetts Medicaid experience. Health Aff14:173–184, 1995.

    Google Scholar 

  44. French MT, Zarkin GA, Hubbard, RL, Rachal, JV The effects of time in drug abuse treatment and employment on posttreatment drug use and criminal activity. Am J Drug and Alcohol Abuse 19(1):19–33, 1993.

    Article  Google Scholar 

  45. Hubbard RL, Marsden ME, Rachal JV, Harwood HJ, Cavanaugh ER, Ginzburg, HM. (1989) Drug Abuse Treatment: A National Study of Effectiveness. Chapel Hill, NC, The University of North Carolina Press, 1989.

    Google Scholar 

  46. Elixhauser A, Luce BR, Taylor WR, Reblando, J: Health care CBA/CEA: An update on the growth and composition of the literature. Med Care Suppl31: JS1–JS11, 1993.

    Article  PubMed  Google Scholar 

  47. Blum TC, Roman, PM: Cost-effectiveness and Preventive Implications ofEmployee Assistance Programs. DHHS Pub. No. (SMA)95-3053. Rockville, MD: US Department of Health and Human Services, Center for Substance Abuse Prevention, 1995.

    Google Scholar 

  48. French MT, Zarkin GA, Bray JW, Hartwell TD: Costs of employee assistance programs: Findings from a national survey. Am JHealth Promotion 11:219–222, 1997.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology and Public Health, and Department of Economics, and Health Services Research Center, University of Miami, Miami, Florida, 33136

    Michael T. French

Authors
  1. Michael T. French
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Kluwer Academic Publishers

About this chapter

Cite this chapter

French, M.T. (2002). Economic Evaluation of Alcohol Treatment Services. In: Alcoholism. Recent Developments in Alcoholism, vol 15. Springer, Boston, MA. https://doi.org/10.1007/978-0-306-47193-3_12

Download citation

  • DOI: https://doi.org/10.1007/978-0-306-47193-3_12

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-306-46441-6

  • Online ISBN: 978-0-306-47193-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation