Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings

Michael F. Fleming, Marlon P. Mundt, Michael French, Linda Baier Manwell, Ellyn A. Stauffacher, Kristen Lawton Barry

Research output: Contribution to journalArticle

248 Citations (Scopus)

Abstract

BACKGROUND. Few studies have estimated the economic costs and benefits of brief physician advice in managed care settings. OBJECTIVE. To conduct a benefit-cost analysis of brief physician advice regarding problem drinking. DESIGN. Patient and health care costs associated with brief advice were compared with economic benefits associated with changes in health care utilization, legal events, and motor vehicle accidents using 6-and 12-month follow-up data from Project TrEAT (Trial for Early Alcohol Treatment), a randomized controlled clinical trial. SUBJECTS. 482 men and 292 women who reported drinking above a threshold limit were randomized into control (n = 382) or intervention (n = 392) groups. MEASURES. Outcomes included alcohol use, emergency department visits, hospital days, legal events, and motor vehicle accidents. RESULTS. No significant differences between control and intervention subjects were present for baseline alcohol use, age, socioeconomic status, smoking, depression or anxiety, conduct disorders, drug use, crimes, motor vehicle accidents, or health care utilization. The total economic benefit of the brief intervention was $423,519 (95% CI: $35,947, $884,848), composed of $195,448 (95% CI: $36,734, $389,160) in savings in emergency department and hospital use and $228,071 (95% CI: -$191,419, $757,303) in avoided costs of crime and motor vehicle accidents. The average (per subject) benefit was $1,151 (95% CI: $92, $2,257). The estimated total economic cost of the intervention was $80,210, or $205 per subject. The benefit-cost ratio was 5.6:1 (95% CI: 0.4, 11.0), or $56,263 in total benefit for every $10,000 invested. CONCLUSIONS. These results offer the first quantitative evidence that implementation of a brief intervention for problem drinkers can generate positive net benefit for patients, the health care system, and society.

Original languageEnglish (US)
Pages (from-to)7-18
Number of pages12
JournalMedical Care
Volume38
Issue number1
StatePublished - Jan 2000

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cost-benefit analysis
Motor Vehicles
Cost-Benefit Analysis
Accidents
Primary Health Care
Patient Acceptance of Health Care
Economics
physician
motor vehicle
Physicians
accident
health care
Alcohols
Crime
costs
Drinking
alcohol
Hospital Emergency Service
Patient Care
economics

Keywords

  • At-risk drinking
  • Benefit-cost analysis
  • Brief intervention
  • Primary care
  • Problem drinking

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Fleming, M. F., Mundt, M. P., French, M., Manwell, L. B., Stauffacher, E. A., & Barry, K. L. (2000). Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings. Medical Care, 38(1), 7-18.

Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings. / Fleming, Michael F.; Mundt, Marlon P.; French, Michael; Manwell, Linda Baier; Stauffacher, Ellyn A.; Barry, Kristen Lawton.

In: Medical Care, Vol. 38, No. 1, 01.2000, p. 7-18.

Research output: Contribution to journalArticle

Fleming, MF, Mundt, MP, French, M, Manwell, LB, Stauffacher, EA & Barry, KL 2000, 'Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings', Medical Care, vol. 38, no. 1, pp. 7-18.
Fleming MF, Mundt MP, French M, Manwell LB, Stauffacher EA, Barry KL. Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings. Medical Care. 2000 Jan;38(1):7-18.
Fleming, Michael F. ; Mundt, Marlon P. ; French, Michael ; Manwell, Linda Baier ; Stauffacher, Ellyn A. ; Barry, Kristen Lawton. / Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings. In: Medical Care. 2000 ; Vol. 38, No. 1. pp. 7-18.
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N2 - BACKGROUND. Few studies have estimated the economic costs and benefits of brief physician advice in managed care settings. OBJECTIVE. To conduct a benefit-cost analysis of brief physician advice regarding problem drinking. DESIGN. Patient and health care costs associated with brief advice were compared with economic benefits associated with changes in health care utilization, legal events, and motor vehicle accidents using 6-and 12-month follow-up data from Project TrEAT (Trial for Early Alcohol Treatment), a randomized controlled clinical trial. SUBJECTS. 482 men and 292 women who reported drinking above a threshold limit were randomized into control (n = 382) or intervention (n = 392) groups. MEASURES. Outcomes included alcohol use, emergency department visits, hospital days, legal events, and motor vehicle accidents. RESULTS. No significant differences between control and intervention subjects were present for baseline alcohol use, age, socioeconomic status, smoking, depression or anxiety, conduct disorders, drug use, crimes, motor vehicle accidents, or health care utilization. The total economic benefit of the brief intervention was $423,519 (95% CI: $35,947, $884,848), composed of $195,448 (95% CI: $36,734, $389,160) in savings in emergency department and hospital use and $228,071 (95% CI: -$191,419, $757,303) in avoided costs of crime and motor vehicle accidents. The average (per subject) benefit was $1,151 (95% CI: $92, $2,257). The estimated total economic cost of the intervention was $80,210, or $205 per subject. The benefit-cost ratio was 5.6:1 (95% CI: 0.4, 11.0), or $56,263 in total benefit for every $10,000 invested. CONCLUSIONS. These results offer the first quantitative evidence that implementation of a brief intervention for problem drinkers can generate positive net benefit for patients, the health care system, and society.

AB - BACKGROUND. Few studies have estimated the economic costs and benefits of brief physician advice in managed care settings. OBJECTIVE. To conduct a benefit-cost analysis of brief physician advice regarding problem drinking. DESIGN. Patient and health care costs associated with brief advice were compared with economic benefits associated with changes in health care utilization, legal events, and motor vehicle accidents using 6-and 12-month follow-up data from Project TrEAT (Trial for Early Alcohol Treatment), a randomized controlled clinical trial. SUBJECTS. 482 men and 292 women who reported drinking above a threshold limit were randomized into control (n = 382) or intervention (n = 392) groups. MEASURES. Outcomes included alcohol use, emergency department visits, hospital days, legal events, and motor vehicle accidents. RESULTS. No significant differences between control and intervention subjects were present for baseline alcohol use, age, socioeconomic status, smoking, depression or anxiety, conduct disorders, drug use, crimes, motor vehicle accidents, or health care utilization. The total economic benefit of the brief intervention was $423,519 (95% CI: $35,947, $884,848), composed of $195,448 (95% CI: $36,734, $389,160) in savings in emergency department and hospital use and $228,071 (95% CI: -$191,419, $757,303) in avoided costs of crime and motor vehicle accidents. The average (per subject) benefit was $1,151 (95% CI: $92, $2,257). The estimated total economic cost of the intervention was $80,210, or $205 per subject. The benefit-cost ratio was 5.6:1 (95% CI: 0.4, 11.0), or $56,263 in total benefit for every $10,000 invested. CONCLUSIONS. These results offer the first quantitative evidence that implementation of a brief intervention for problem drinkers can generate positive net benefit for patients, the health care system, and society.

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