TY - JOUR
KW - Alcoholism/prevention & control
KW - Cost-Benefit Analysis
KW - Counseling/economics/methods
KW - Humans
KW - Primary Health Care/economics
KW - Quality-Adjusted Life Years
KW - United States
AU - L. I. Solberg
AU - M. V. Maciosek
AU - N. M. Edwards
A1 - 
AB - BACKGROUND: The U.S. Preventive Services Task Force (USPSTF) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse. This study was designed to develop a standardized rating for the clinically preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services. METHODS: A systematic review of the literature from 1992 through 2004 to identify relevant randomized controlled trials and cost-effectiveness studies was completed in 2005. Clinically preventable burden (CPB) was calculated as the product of effectiveness times the alcohol-attributable fraction of both mortality and morbidity (measured in quality-adjusted life years or QALYs), for all relevant conditions. Cost effectiveness from both the societal perspective and the health-system perspective was estimated. These analyses were completed in 2006. RESULTS: The calculated CPB was 176,000 QALYs saved over the lifetime of a birth cohort of 4,000,000, with a range in sensitivity analysis from -43% to +94% (primarily due to variation in estimates of effectiveness). Screening and brief counseling was cost-saving from the societal perspective and had a cost-effectiveness ratio of $1755/QALY saved from the health-system perspective. Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving. CONCLUSIONS: These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using standardized methods. Since current levels of delivery are the lowest of comparably ranked services, this service deserves special attention by clinicians and care delivery systems.
BT - American Journal of Preventive Medicine
C5 - Financing & Sustainability
CP - 2
CY - Netherlands
DO - 10.1016/j.amepre.2007.09.035
IS - 2
JF - American Journal of Preventive Medicine
N2 - BACKGROUND: The U.S. Preventive Services Task Force (USPSTF) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse. This study was designed to develop a standardized rating for the clinically preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services. METHODS: A systematic review of the literature from 1992 through 2004 to identify relevant randomized controlled trials and cost-effectiveness studies was completed in 2005. Clinically preventable burden (CPB) was calculated as the product of effectiveness times the alcohol-attributable fraction of both mortality and morbidity (measured in quality-adjusted life years or QALYs), for all relevant conditions. Cost effectiveness from both the societal perspective and the health-system perspective was estimated. These analyses were completed in 2006. RESULTS: The calculated CPB was 176,000 QALYs saved over the lifetime of a birth cohort of 4,000,000, with a range in sensitivity analysis from -43% to +94% (primarily due to variation in estimates of effectiveness). Screening and brief counseling was cost-saving from the societal perspective and had a cost-effectiveness ratio of $1755/QALY saved from the health-system perspective. Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving. CONCLUSIONS: These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using standardized methods. Since current levels of delivery are the lowest of comparably ranked services, this service deserves special attention by clinicians and care delivery systems.
PP - Netherlands
PY - 2008
SN - 0749-3797; 0749-3797
SP - 143
EP - 152
EP - 
T1 - Primary care intervention to reduce alcohol misuse ranking its health impact and cost effectiveness
T2 - American Journal of Preventive Medicine
TI - Primary care intervention to reduce alcohol misuse ranking its health impact and cost effectiveness
U1 - Financing & Sustainability
U2 - 18201645
U3 - 10.1016/j.amepre.2007.09.035
VL - 34
VO - 0749-3797; 0749-3797
Y1 - 2008
ER -