| Understanding the costs and benefits of resources used to provide substance abuse treatment is essential to policymakers, payers, and providers of care. Economic analyses are an important component of research for informing these stakeholders about the relationship between resource use, treatment planning, and client and societal outcomes of substance abuse treatment. Such analyses have ranged from cost analyses of specific treatment interventions to econometric modeling of the relationship between organization, treatment, and client outcomes. The objective of this dissertation is to expand and refine economic analysis of substance abuse treatment in the areas of cost data collection, cost function modeling, and cost-effectiveness analysis of brief intervention. The findings are presented in the three-paper format.; Based on a pilot cost study of nine treatment programs, the first paper examines the ability of substance abuse treatment program staff to respond to two survey instruments designed to ascertain the costs of their programs: the Drug Abuse Treatment Cost Analysis Program (DATCAP) and the Cost Data Audit Instrument (CDAI).; The second paper describes econometric analyses of organizational, client, and cost data collected from outpatient substance abuse treatment programs sampled in Phase II of the Alcohol and Drug Services Study (ADSS). Microeconomic cost theory and cost functions as applied to hospital services serve as the framework for developing a cost function for outpatient substance abuse treatment services using the ADSS data. The two dependent variables are the cost per episode and the cost per enrollment day. Independent variables include organizational variables such as point prevalence, type of ownership, average length of stay, the number of visits per enrollment day, as well as client characteristics such as gender, age, minority status, co-morbidity, and primary drug of choice.; The third paper involves a benefit-cost analysis of a clinical trial of a peer educator brief intervention for cocaine and heroin patients, called Project Link that took place at Boston Medical Center from 1997--2002. The Drug Abuse Treatment Cost Analysis Program (DATCAP) was used to examine institutional and client costs while the generalized estimating equations method was used to examine medical cost-offsets one year post-intervention using an administrative dataset. (Abstract shortened by UMI.)... |
