Economic evaluation of alcohol treatment services

The objective of this paper is to summarize and critically review the most recent literature on economic evaluation of alcohol treatment services, ide ntify information gaps, and suggest a research agenda for the future. The f ocus of the review is research published after 1995, although some of the e arlier economic studies are also included. Research findings in the literat ure provide evidence for the following. First, for many alcoholics, day hos pital treatment or even less intensive outpatient services are cost-effecti ve alternatives to inpatient treatment. Second, alcoholism treatment often results in declining health care costs for alcoholics who are covered by pr ivate health insurance, Third, though the use of alcoholics anonymous (AA) as an alternative to more structured alcohol treatment services may be cost -effective, substance abuse outcomes from AA are sometimes less favorable a nd the risk of relapse is higher. Fourth, methods have recently been develo ped to estimate the dollar value of alcohol treatment outcomes such as avoi ded absenteeism, increased productivity, improved health, and avoided crime . Based on these findings and developments, new treatment approaches and ch anges in service delivery systems require a fresh perspective on the costs and benefits of alternative treatment services. The findings from economic evaluation studies must be reported in clear and nontechnical terms to an a udience of clinicians and politicians so that they can be used in the proce ss of decision making. (C) 2000 Elsevier Science Ltd. All rights reserved.