Costs of an Alcohol Measurement Intervention in Three Latin American Countries.

Adriana Solovei,Augusto Pérez Gómez,Marina Piazza,Inés Bustamante,Guillermina Natera Rey,Juliana Mejía Trujillo,Miriam Arroyo,Eva Jané Llopis,Liesbeth Mercken,Jakob Manthey,Jürgen Rehm,Peter Anderson,Alejandra Pérez De León,Silvia Evers,Hein De Vries

doi:10.3390/ijerph19020700

Abstract

Alcohol measurement in health care settings is an effective intervention for reducing alcohol-related harm. However, in many countries, costs related to alcohol measurement have not yet been transparently assessed, which may hinder its adoption and implementation. Costs of an alcohol measurement programme in three upper-middle-income Latin American countries were assessed via questionnaires and compared, as part of the quasi-experimental SCALA study. Additional to the intervention costs, the costs of three implementation strategies: standard training and clinical package, intensive training and clinical package, and community support, were assessed and subsequently translated into costs per additional alcohol measurement session. Results demonstrated that costs for one alcohol measurement session ranged between Int$ 0.67 and Int$ 1.23 in Colombia, Int$ 1.19 and Int$ 2.57 in Mexico, and Int$ 1.11 and Int$ 2.14 in Peru. Costs were mainly driven by the salaries of the health professionals. Implementation strategies costs per additional alcohol measurement session ranged between Int$ 1.24 and Int$ 6.17. In all three countries, standard training and a clinical package may be a promising implementation strategy with a relatively low cost per additional alcohol measurement session.

Highlights

Alcohol use is one of the leading preventable risk factors for health and social harms, causing an estimated three million deaths worldwide each year [1]
In Colombia and Mexico, over 60% of the sessions were given by GPs, followed by nurses and psychologists, whereas in Peru a third of the sessions were given by midwives and a third by psychologists, followed by nurses, nurses technicians, and GPs
This paper aimed to assess the consultation costs of delivering alcohol measurement sessions in PHC settings in three Latin American countries, along with the programme costs of three implementation strategies aiming to support the implementation of this intervention: (1) standard training and clinical package, (2) intensive training and clinical package, and (3) community support, including the costs of these implementation strategies per additional alcohol measurement session

Summary

Introduction

Alcohol use is one of the leading preventable risk factors for health and social harms, causing an estimated three million deaths worldwide each year [1]. More than 200 disease and injury categories are either partly (e.g., various cancer subtypes, ischemic heart disease, liver cirrhosis, and traffic injury) or entirely (e.g., alcohol-use disorders and foetal alcohol syndrome) caused by alcohol [2]. This includes negative social consequences, which go beyond the health care sector, such as interpersonal violence, self-harm, vandalism, criminality, and work-related losses of productivity [3]. 3.1%) in middle- and high-income countries, including health care and criminal justice costs, as well as losses in productivity. In the three countries addressed in this paper, alcohol consumption is a top-five leading cause of mortality and premature death [5]

Objectives

Results

Conclusion