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 st and ardized methods .
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 design ed to develop a st and ardized rating for the clinical ly preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services .
Brief interventions for at-risk drinking: patient outcomes and cost-effectiveness in managed care organizations.
AIMS Evaluate effectiveness and costs of brief interventions for patients screening positive for at-risk drinking in managed health care organizations ( MCOs ) . METHODS A pre-post , quasi-experimental , multi-site evaluation conducted at 15 clinic sites within five MCO setting s. At-risk drinkers ( N = 1329 ) received either : ( i ) brief intervention delivered by licensed practitioners ; or ( ii ) brief intervention delivered by mid-level professional specialists ( nurses ) ; or ( iii ) usual care ( comparison condition ) . Clinics were r and omly assigned to three study conditions . Data were collected on the cost of screening and brief intervention . Follow-up interviews were conducted at 3 and 12 months . RESULTS Participants in all three study conditions were drinking significantly less at 3-month follow-up , but the decline was significantly greater in the two intervention groups than in the control group . There were no significant differences between the two intervention conditions . Of the patients in the intervention conditions 60 % reduced their alcohol consumption by > or = 1 drink per week , compared with 53 % of those in the control condition . No differences were found on a measure of the quality of life . Differential reductions in weekly alcohol consumption between intervention and control groups were significant at 12-month follow-up . Average incremental costs of the interventions were 4.16 US dollar per patient using licensed practitioners and 2.82 US dollar using mid-level specialists . CONCLUSION Alcohol screening and brief intervention when implemented in managed care organizations produces modest , statistically significant reductions in at-risk drinking . Interventions delivered to a common protocol by mid-level specialists are as effective as those delivered by licensed practitioners at about two-thirds the cost
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 st and ardized methods .
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 design ed to develop a st and ardized rating for the clinical ly preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services .