Effectiveness and cost-effectiveness of four treatment modalities for substance disorders: a propensity score analysis.
Health Serv Res
; 38(1 Pt 1): 233-59, 2003 Feb.
Article
em En
| MEDLINE
| ID: mdl-12650390
ABSTRACT
OBJECTIVE:
To assess the effectiveness and cost-effectiveness of four treatment modalities for substance abuse. DATA SOURCES The study used data from the Services Research Outcomes Study (SROS), a survey of 3,047 clients in a random sample of 99 drug treatment facilities across the United States. Detailed sociodemographic, substance use, and clinical data were abstracted from treatment records. Substance abuse outcome and treatment history following discharge from index facilities were assessed using a comprehensive interview with 1,799 of these individuals five years after discharge. Treatment success was defined in two ways as abstinence and as any reduction in substance use. STUDYDESIGN:
Effectiveness and cost-effectiveness of four modalities were compared inpatient, residential, outpatient detox/methadone, and outpatient drug-free. Clients were stratified based on propensity scores and analyses were conducted within these strata. Sensitivity analyses examined the impact of future substance abuse treatment on effectiveness and cost-effectiveness estimates. PRINCIPALFINDINGS:
Treatment of substance disorders appears to be cost-effective compared to other health interventions. The cost per successfully treated abstinent case in the least costly modality, the outpatient drug-free programs, was 6,300 dollars (95 percent confidence intervals 5,200-7,900 dollars) in 1990 dollars. There were only minor differences between various modalities of treatment with regard to effectiveness. However, modalities varied considerably with regard to cost-effectiveness. Outpatient drug-free programs were the most cost-effective. There was little evidence that relative effectiveness or cost-effectiveness of programs varied according to factors that were associated with selection into different programs.CONCLUSIONS:
Substance disorders can be treated most cost-effectively in outpatient drug-free settings. Savings from transitioning to the most cost-effective treatment modality may free resources that could be reinvested to improve access to substance abuse treatment for a larger number of individuals in need of such treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ambulatório Hospitalar
/
Avaliação de Resultados em Cuidados de Saúde
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Custos de Cuidados de Saúde
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Centros de Tratamento de Abuso de Substâncias
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Transtornos Relacionados ao Uso de Substâncias
Tipo de estudo:
Health_economic_evaluation
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2003
Tipo de documento:
Article