Suchergebnisse

Federal, State, and local government agencies require current and accurate cost information for publicly funded substance abuse treatment programs to guide program assessments and reimbursement decisions. The Center for Substance Abuse Treatment (CSAT) published a list of modality-specific cost bands for this purpose in 2002. However, the upper and lower values in these ranges are so wide that they offer little practical guidance for funding agencies. Thus, the dual purpose of this investigation was to assemble the most current and comprehensive set of economic cost estimates from the readily-available literature and then use these estimates to develop updated modality-specific cost bands for more reasonable reimbursement policies. Although cost estimates were scant for some modalities, the recommended cost bands are based on the best available economic research, and we believe these new ranges will be more useful and pertinent for all stakeholders of publicly-funded substance abuse treatment.

OBJECTIVE: To disentangle the relationships among food insecurity, health care utilization, and health care expenditures. DATA SOURCES/STUDY SETTING: We use national data on 13 465 adults (age ≥ 18) from the 2016 Medical Expenditure Panel Survey (MEPS), the first year of the food insecurity measures. STUDY DESIGN: We employ two‐stage empirical models (probit for any health care use/expenditure, ordinary least squares, and generalized linear models for amount of utilization/expenditure), controlling for demographics, health insurance, poverty status, chronic conditions, and other predictors. PRINCIPAL FINDINGS: Our results show that the likelihood of any health care expenditure (total, inpatient, emergency department, outpatient, and pharmaceutical) is higher for marginal, low, and very low food secure individuals. Relative to food secure households, very low food secure households are 5.1 percentage points (P < .001) more likely to have any health care expenditure, and have total health care expenditures that are 24.8 percent higher (P = .011). However, once we include chronic conditions in the models (ie, high blood pressure, heart disease, stroke, emphysema, high cholesterol, cancer, diabetes, arthritis, and asthma), these underlying health conditions mitigate the differences in expenditures by food insecurity status (only the likelihood of any having any health care expenditure for very low food secure households remains statistically significant). CONCLUSIONS: Policy makers and government agencies are focused on addressing deficiencies in social determinants of health and the resulting impacts on health status and health care utilization. Our results indicate that chronic conditions are strongly associated with food insecurity and higher health care spending. Efforts to alleviate food insecurity should consider the dual burden of chronic conditions. Finally, future research can address specific mechanisms underlying the relationships between food security, health, and health care.

Do job applicants and employees with tattoos suffer a penalty in the labor market because of their body art? Previous research has found that tattooed people are widely perceived by hiring managers to be less employable than people without tattoos. This is especially the case for those who have visible tattoos (particularly offensive ones) that are difficult to conceal. Given this backdrop, our research surprisingly found no empirical evidence of employment, wage or earnings discrimination against people with various types of tattoos. In our sample, and considering a variety of alternative estimation techniques, not only are the wages and annual earnings of tattooed employees in the United States statistically indistinguishable from the wages and annual earnings of employees without tattoos, but tattooed individuals are also just as likely, and in some instances even more likely, to gain employment. These results suggest that, contrary to popular opinion as well as research findings with hiring managers and customers, having a tattoo does not appear to be associated with disadvantage or discrimination in the labor market.

Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than ten years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost of society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime.

Purpose. Investigate the relationship between alcohol consumption and physical activity because understanding whether there are common determinants of health behaviors is critical in designing programs to change risky activities. Design. Cross-sectional analysis. Setting. United States. Subjects. A sample of adults representative of the U.S. population (N = 230,856) from the 2005 Behavioral Risk Factor Surveillance System. Measures. Several measures of drinking and exercise were analyzed. Specifications included numerous health, health behavior, socioeconomic, and demographic control variables. Results. For women, current drinkers exercise 7.2 more minutes per week than abstainers. Ten extra drinks per month are associated with 2.2 extra minutes per week of physical activity. When compared with current abstainers, light, moderate, and heavy drinkers exercise 5.7, 10.1, and 19.9 more minutes per week. Drinking is associated with a 10.1 percentage point increase in the probability of exercising vigorously. Ten extra drinks per month are associated with a 2.0 percentage point increase in the probability of engaging in vigorous physical activity. Light, moderate, and heavy drinking are associated with 9.0, 14.3, and 13.7 percentage point increases in the probability of exercising vigorously. The estimation results for men are similar to those for women. Conclusions. Our results strongly suggest that alcohol consumption and physical activity are positively correlated. The association persists at heavy drinking levels.

The chronic and relapsing nature of substance abuse points to the need for continuing care after a primary phase of treatment. This article reviews the economic studies of continuing care, discusses research gaps, highlights some of the challenges of conducting rigorous economic evaluations of continuing care, and offers research guidelines and recommendations for future economic studies in this emerging field. Rigorous economic evaluations are needed by health care providers and policy makers to justify the allocation of scarce resources to continuing care interventions. The adoption of cost-effective continuing care services can reduce long-term consequences of addiction, thereby potentially increasing overall social welfare.

Considerable national attention has focused recently on the adverse consequences of illicit drug use. While several studies estimate the relationship between illicit drug use and wages, the findings are inconsistent. Surprisingly, some researchers identify a positive and statistically significant relationship between wages and drug use for young adults. Motivated by this counter‐intuitive finding, this paper compiles unique data on employees at six worksites in order to explore the relationships among drug use, wages, and absenteeism. Using various measures of current and lifetime drug use and accounting for alcohol‐use comorbidity, the authors find predominantly insignificant relationships (both direct and indirect) between drug use and both wages and absenteeism, regardless of gender.

Employee assistance programs (MPs) represent a relatively new fringe benefit for workers; the number of these programs has been steadily increasing in worksites of all sizes. Despite this surge in the growth of EAPs, few studies have estimated their costs or benefits. To guide future economic evaluation studies of EAPs, we have developed a methodology that has four components: a process description to understand the structure, operating environment, and goals of the EAP; a cost analysis to comprehensively identify and estimate the full range of EAP costs; an outcomes analysis to rigorously estimate the effectiveness of the EAP for groups of employees and the overall impact of the EAP on employee performance and workplace productivity; and an economic evaluation to estimate cost-effectiveness ratios, dollar benefits, and net benefits of the EAP. Our methodology is based on standard economic theory, but we present the evaluation strategy in a nontechnical way so that it can be used by employers and other researchers to estimate the costs and benefits of EAPs.