TY - JOUR KW - Adolescent KW - Adult KW - Aged KW - Alcoholism/prevention & control KW - Cost of Illness KW - Cost Savings KW - Cost-Benefit Analysis KW - Counseling/economics/methods KW - Emergency Service, Hospital/economics/utilization KW - Female KW - Follow-Up Studies KW - Health Care Costs/statistics & numerical data KW - Hospitalization/economics KW - Humans KW - Male KW - Managed Care Programs/standards KW - Middle Aged KW - Primary Health Care/economics/standards KW - Program Evaluation KW - Treatment Outcome KW - Wisconsin AU - M. F. Fleming AU - M. P. Mundt AU - M. T. French AU - L. B. Manwell AU - E. A. Stauffacher AU - K. L. Barry A1 - 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. BT - Medical care C5 - Financing & Sustainability CP - 1 CY - UNITED STATES IS - 1 JF - Medical care 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. PP - UNITED STATES PY - 2000 SN - 0025-7079; 0025-7079 SP - 7 EP - 18 EP - T1 - Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings T2 - Medical care TI - Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings U1 - Financing & Sustainability U2 - 10630716 VL - 38 VO - 0025-7079; 0025-7079 Y1 - 2000 ER -