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A national estimate of costs of drug and alcohol treatment: the ADSS cost study Donald S Shepard1 Aa

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2 Family Health International, Research Triangle Park, NC. Oct. 24-26, 2005. Shepard_at_Brandeis.edu ... as the steady state relationship among admissions, length ... – PowerPoint PPT presentation

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Title: A national estimate of costs of drug and alcohol treatment: the ADSS cost study Donald S Shepard1 Aa


1
A national estimate of costs of drug and alcohol
treatment the ADSS cost study Donald S
Shepard1 Aaron Beaston-Blaakman2 Constance
Horgan1 1 Brandeis University, Schneider
Institute for Health Policy, Waltham, MA 2 Family
Health International, Research Triangle Park, NC
  • Oct. 24-26, 2005
  • Shepard_at_Brandeis.edu
  • Tel 781 736 3975
  • Brandeis University, Waltham MA 02454

Brandeis University
2
Introduction The Alcohol and Drug Services
Study (ADSS)
  • ADSS is a national study of over 2,300 treatment
    programs
  • It was designed to collect data describing
    characteristics of substance abuse treatment
    facilities including clients in treatment,
    treatment outcomes, and facility organizational
    characteristics and costs of treatment within the
    specialty sector.
  • The ADSS Cost Study represents the first known
    compilation of costs of a comprehensive,
    nationally representative sample of substance
    abuse treatment facilities.
  • Within the specialty sector, the study was
    developed to estimate both national treatment
    costs and average cost per episode and per
    enrollment day.

Brandeis University
3
Challenge Obtaining Reliable Cost Data from a
Large Sample of Treatment Facilities
  • Needed precision required including 319 programs
    in 280 facilities, but time and budget
    constraints were insufficient for site visits by
    trained financial or economic analysts. Treatment
    facilities are heterogeneous by size and scope
  • Financial data for a sampled program are
    intertwined with other programs
  • Program managers have little time and training
    for the compilation and analysis of cost data.
  • The federal Paperwork Reduction Act (OMB
    clearance) requires minimizing the time burden on
    each respondent.

Brandeis University
4
Methods The triangle
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5
Methods A two-step approach to obtain reliable
cost data
  • Step One An interviewer with only a few days of
    generalized training recorded initial answers to
    the ADSS Phase II questionnaire with no data
    checking.
  • Step Two A masters level cost analyst performed
    an extensive telephone update of questionable
    items using a specially designed Excel costing
    instrument containing about 50 checks of
    plausibility, logic, and internal consistency,
    such as the steady state relationship among
    admissions, length of stay, and point prevalence.

Brandeis University
6
Methods Consistency
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7
Results data revisions
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8
Results personnel costs as of total costs
9
Results Average time requirements per facility
  • Cost analyst time 4 hours
  • Facility staff (program director, financial
    officer, information officer combined) 4 hours
  • Average facility cooperation rate 99

Brandeis University
10
Cost per counseling hour in outpatient
non-methadone facilities (1997)
n 215 average of 9.6 clients attend each
group session
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11
Results average costs per admission
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12
Results average costs per enrolled client day
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13
Conclusions Limitations
  • Does not identify costs of an individual client.
  • Provides little detail about non-personnel costs

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14
Conclusions Strengths
  • Provides an efficient and accurate approach to
    ascertain the costs of a substance abuse
    treatment program.
  • Serves as basis for estimating national spending,
    norms for unit costs, and source for econometric
    studies.
  • Instrument forms the foundation of the Treatment
    Cost Assessment Tool (TCAT)
  • Findings used in econometric studies by Duffy et
    al. (2004) and Beaston-Blaakman et al. (2005)

Brandeis University
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