The 130th Annual Meeting of APHA

Abstract #51271

Donald S. Shepard, PhD¹, Aaron Beaston-Blaakman, MSW, MPA, and Constance M. Horgan, ScD³. (1) Schneider Institute for Health Policy, Heller School, Brandeis University, MS 035, 415 South Street, Waltham, MA 02454-9110, 781-736-3975, shepard@brandeis.edu, (2) Schneider Institute for Health Policy, Heller Graduate School, Brandeis University, 415 South Street, Waltham, MA 02454

Within the Alcohol and Drug Services Study (ADSS), a nationally representative cluster sample of treatment facilities and their clients, the ADSS Cost Study obtained information on the costs and revenues of 280 facilities. As public financing dominates substance abuse treatment and demand often exceeds available slots, policy makers are keenly interested in variations across and within types of care to stretch available dollars. Using an interactive spreadsheet with a telephone interview to perform some 50 consistency checks, the cost study obtained cooperation from 99% of facilities chosen. ADSS found that the average cost per admission varied substantially both between and within each of the three types of care. The average cost per admission (± SEM) ranged from $5,944 ± $2,294 for outpatient methadone, $3,134 ± $602 for residential care, and $1,141 ± $274. for outpatient non-methadone facilities. Within modality, the study examined facility characteristics such as ownership, size, output, and provision of wrap around services using weighted regressions. For example, among the 222 facilities providing outpatient non-methadone care, multiple regression found that ownership was a significant predictor of average cost per admission (p=0.03). The corresponding predicted average costs were $1390 in private for profit facilities, $1464 in public facilities and $2023 in private non-profit facilities. Many other client and facility characteristics are also significant predictors of cost per admission and cost per patient day.

Learning Objectives:

• At the end of the session, participants will be able to describe how analytic techniques of economics can be applied to costs of providing substance abuse treatment, in a large and nationally representative data set.

Keywords: Substance Abuse Treatment, Cost Issues

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.