Janice L Pringle1, David K Kelley2, Shannon M Kearney1, Arnie Aldridge3, William Dowd4, William Johnjulio5, Arvind Venkat6, Michael Madden7, John Lovelace8. 1. Program Evaluation and Research Unit, School of Pharmacy, University of Pittsburgh, Pittsburgh. 2. Office of Medical Assistance Programs, Pennsylvania Department of Human Services, Harrisburg, PA. 3. RTI International, Durham. 4. Behavioral Health Economics Program, RTI International, Research Triangle Park, NC. 5. Department of Family Medicine, Allegheny Health Network, Monroeville. 6. Research and Faculty Academic Affairs, Department of Emergency Medicine, Allegheny General Hospital. 7. Gateway Health Plan, Four Gateway Center. 8. UPMC For You, University of Pittsburgh Medical Center Health Plan, US Steel Tower, Pittsburgh, PA.
Abstract
BACKGROUND: There is increasing interest in deploying screening, brief intervention, and referral to treatment (SBIRT) practices in emergency departments (ED) to intervene with patients at risk for substance use disorders. However, the current literature is inconclusive on whether SBIRT practices are effective in reducing costs and utilization. OBJECTIVE: This study sought to evaluate the health care costs and health care utilization associated with SBIRT services in the ED. RESEARCH DESIGN: This study analyzed downstream health care utilization and costs for patients who were exposed to SBIRT services within an Allegheny County, Pennsylvania, ED through a program titled Safe Landing compared with 3 control groups of ED patients (intervention hospital preintervention, and preintervention and postintervention time period at a comparable, nonintervention hospital). SUBJECTS: The subjects were patients who received ED SBIRT services from January 1 to December 31 in 2012 as part of the Safe Landing program. One control group received ED services at the same hospital during a previous year. Two other control groups were patients who received ED services at another comparable hospital. MEASURES: Measures include total health care costs, 30-day ED visits, 1-year ED visits, inpatient claims, and behavioral health claims. RESULTS: Results found that patients who received SBIRT services experienced a 21% reduction in health care costs and a significant reduction in 1-year ED visits (decrease of 3.3 percentage points). CONCLUSIONS: This study provides further support that SBIRT programs are cost-effective and cost-beneficial approaches to substance use disorders management, important factors as policy advocates continue to disseminate SBIRT practices throughout the health care system.
BACKGROUND: There is increasing interest in deploying screening, brief intervention, and referral to treatment (SBIRT) practices in emergency departments (ED) to intervene with patients at risk for substance use disorders. However, the current literature is inconclusive on whether SBIRT practices are effective in reducing costs and utilization. OBJECTIVE: This study sought to evaluate the health care costs and health care utilization associated with SBIRT services in the ED. RESEARCH DESIGN: This study analyzed downstream health care utilization and costs for patients who were exposed to SBIRT services within an Allegheny County, Pennsylvania, ED through a program titled Safe Landing compared with 3 control groups of ED patients (intervention hospital preintervention, and preintervention and postintervention time period at a comparable, nonintervention hospital). SUBJECTS: The subjects were patients who received ED SBIRT services from January 1 to December 31 in 2012 as part of the Safe Landing program. One control group received ED services at the same hospital during a previous year. Two other control groups were patients who received ED services at another comparable hospital. MEASURES: Measures include total health care costs, 30-day ED visits, 1-year ED visits, inpatient claims, and behavioral health claims. RESULTS: Results found that patients who received SBIRT services experienced a 21% reduction in health care costs and a significant reduction in 1-year ED visits (decrease of 3.3 percentage points). CONCLUSIONS: This study provides further support that SBIRT programs are cost-effective and cost-beneficial approaches to substance use disorders management, important factors as policy advocates continue to disseminate SBIRT practices throughout the health care system.
Authors: Brian C Shonesy; Donald Williams; Damian Simmons; Erin Dorval; Stuart Gitlow; Richard M Gustin Journal: J Addict Med Date: 2019 Sep/Oct Impact factor: 3.702
Authors: Ashley L Merianos; Kayleigh A Fiser; E Melinda Mahabee-Gittens; Michael S Lyons; Judith S Gordon Journal: Implement Sci Commun Date: 2022-01-12