Economic evaluation of Substance Abuse and Mental Health Services Administration (SAMHSA)'s Center for Substance Abuse Treatment (CSAT) Screening, Brief Intervention and Referral to Treatment (SBIRT)

The Substance Abuse and Mental Health Services Agency (SAMHSA) Center for Substance Abuse Treatment (CSAT) funded the implementation of evidence-based models of screening and brief intervention into emergency departments, primary care clinics, hospitals, and public health departments in six US states and one tribal organization. The cross-site evaluation of this initiative documents the barriers to implementation of various SBIRT models, measures the impact of SBIRT on the substance use behaviors of patients presenting at the healthcare settings, and provides an economic analysis of the SBIRT models and patient outcomes. The economic component of the evaluation uses an activity-based approach to estimate the cost of conducting SBIRT in these settings along with a program-level costing component which informs model sustainability and future replication efforts.

The economic evaluation estimates the cost of implementing various existing SBIRT models, model components and can be used to estimate costs of combinations of various model components (e.g. emergency department nurse practitioners using motivational interviewing). Estimating costs at the activity level permits identification of the key cost components of SBIRT programs and the efficiencies of certain model component interactions. The economic evaluation also estimates SBIRT implementation costs on the program level, using information on training, administrative and managerial-level costs of labor, office space and supplies collected from grantees. These two cost studies, program- and service-level, provide a holistic approach to understanding the costs of implementing an SBIRT program. In this presentation we discuss several implications for sustainability as well as results from cost-effectiveness and cost benefit analyses.