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Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs
This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT) services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across imple...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085323/ https://www.ncbi.nlm.nih.gov/pubmed/25114610 http://dx.doi.org/10.2147/SAR.S62127 |
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author | Bray, Jeremy W Mallonee, Erin Dowd, William Aldridge, Arnie Cowell, Alexander J Vendetti, Janice |
author_facet | Bray, Jeremy W Mallonee, Erin Dowd, William Aldridge, Arnie Cowell, Alexander J Vendetti, Janice |
author_sort | Bray, Jeremy W |
collection | PubMed |
description | This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT) services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist) and service delivery setting (emergency department, hospital inpatient, outpatient). Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service provision for some settings and implementation models. |
format | Online Article Text |
id | pubmed-4085323 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-40853232014-08-11 Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs Bray, Jeremy W Mallonee, Erin Dowd, William Aldridge, Arnie Cowell, Alexander J Vendetti, Janice Subst Abuse Rehabil Original Research This paper examines the costs of delivering screening, brief intervention, and referral to treatment (SBIRT) services within the first seven demonstration programs funded by the US Substance Abuse and Mental Health Services Administration. Service-level costs were estimated and compared across implementation model (contracted specialist, inhouse specialist, inhouse generalist) and service delivery setting (emergency department, hospital inpatient, outpatient). Program-level costs were estimated and compared across grantee recipient programs. Service-level data were collected through timed observations of SBIRT service delivery. Program-level data were collected during key informant interviews using structured cost interview guides. At the service level, support activities that occur before or after engaging the patient comprise a considerable portion of the cost of delivering SBIRT services, especially short duration services. At the program level, average costs decreased as more patients were screened. Comparing across program and service levels, the average annual operating costs calculated at the program level often exceeded the cost of actual service delivery. Provider time spent in support of service provision may comprise a large share of the costs in some cases because of potentially substantial fixed and quasifixed costs associated with program operation. The cost structure of screening, brief intervention, and referral to treatment is complex and discontinuous of patient flow, causing annual operating costs to exceed the costs of actual service provision for some settings and implementation models. Dove Medical Press 2014-07-01 /pmc/articles/PMC4085323/ /pubmed/25114610 http://dx.doi.org/10.2147/SAR.S62127 Text en © 2014 Bray et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Bray, Jeremy W Mallonee, Erin Dowd, William Aldridge, Arnie Cowell, Alexander J Vendetti, Janice Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs |
title | Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs |
title_full | Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs |
title_fullStr | Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs |
title_full_unstemmed | Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs |
title_short | Program- and service-level costs of seven screening, brief intervention, and referral to treatment programs |
title_sort | program- and service-level costs of seven screening, brief intervention, and referral to treatment programs |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085323/ https://www.ncbi.nlm.nih.gov/pubmed/25114610 http://dx.doi.org/10.2147/SAR.S62127 |
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