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Assessing the costs of delivering group-versus individual-based treatment to substance-abusing patients: Administrative versus societal perspectives

Keith C. Klostermann, PhD1, Brian T. Yates, PhD2, and William Fals-Stewart, PhD1. (1) Research Institute on Addictions, State University of New York, University at Buffalo, 1021 Main Street, Buffalo, NY 14203-1016, (716) 887-2530, kkloster@ria.buffalo.edu, (2) Dept. of Psychology, American University, 4400 Mass. Ave., N.W., American University, Washington, DC 20016-8062

In most substance abuse treatment programs, the two primary modalities of therapy delivery are either individual-based treatment (i.e., IBT; one counselor meeting for a clinical hour with one patient) or group-based treatment (i.e., GBT; one or two counselors meeting with 6-10 patients for 60-90 minutes). However, IBT has largely given way to GBT as the primary treatment modality. One reason for this is that GBTs are more cost-efficient to deliver than IBT (i.e., one therapist treating multiple patients simultaneously). Few studies to date have compared the cost of delivering GBTs versus IBTs for substance-abusing patients. Moreover, those investigations that have examined delivery costs have done so from a purely administrative perspective (e.g., rental space to conduct sessions, counselor salaries, agency overhead). However, several recent reviews have strongly recommended that assessment of costs assume a societal perspective, in which any costs incurred during the delivery of a given intervention are measured. This would not only include administrative costs, but also those incurred by the patients (e.g., transportation, child care, lost wages). The purpose of this investigation was to compare the costs of delivering IBTs versus GBTs in one of two outpatient treatment programs for substance abuse during a 1-year period, both from an administrative and societal perspective. Although GBTs were significantly less costly to deliver per patient than IBTs from either perspective, the magnitude of this advantage decreased significantly when calculated from a societal perspective versus an administrative perspective. Findings have important implications for evaluating cost-benefits and cost-effectiveness of IBTs and GBTs.

Learning Objectives:

Keywords: Cost Issues,

Related Web page: www.addictionandfamily.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Research Institute on Addictions State University of New York, University at Buffalo 1021 Main Street Buffalo, New York 14203-1016
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.

Approaches to Substance Abuse Treatment Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA