Abstract
BackgroundStandardization and harmonization of healthcare resource utilization data can improve evaluations of the economic impact of treating people with substance use disorder (SUD), including reductions in use of expensive hospital and emergency department (ED) services, and can ensure consistency with current cost-effectiveness and cost-benefit analysis guidelines.MethodsWe examined self-reported healthcare and other resource utilization data collected at baseline from three National Institute on Drug Abuse (NIDA)-funded Seek, Test, Treat, and Retain intervention studies of individuals living with/at risk for HIV with SUD. Costs were calculated by multiplying mean healthcare resource utilization measures by monetary conversion factors reflecting cost per unit of care. We normalized baseline recall timeframes to past 30 days and evaluated for missing data.ResultsWe identified measures that are feasible and appropriate for estimating healthcare sector costs including ED visits, inpatient hospital and residential facility stays, and outpatient encounters. We also identified two self-reported measures to inform societal costs (days experiencing SUD problems, participant spending on substances). Missingness was 8% or less for all study measures and was lower for single questions measuring utilization in a recall period.ConclusionsWe recommend including measures representing units of service with specific recall periods (e.g., 6 months vs. lifetime), and collecting healthcare resource utilization data using single-question measures to reduce missingness.
Highlights
Standardization and harmonization of healthcare resource utilization data can improve evaluations of the economic impact of treating people with substance use disorder (SUD), including reductions in use of expensive hospital and emergency department (ED) services, and can ensure consistency with current costeffectiveness and cost-benefit analysis guidelines
To inform data harmonization goals, we examined self-reported baseline data from three of the STTR studies to compare measures of healthcare resource utilization, evaluate the potential for combining these measures to estimate healthcare costs, and provide guidance for future studies on how to adopt healthcare resource utilization measures that are appropriate for economic evaluation
We identified healthcare resource utilization measures common to at least two of the selected studies with comparable recall periods, and categorized them into three domains: general medical care, SUD treatment (e.g., times treated for alcohol use disorder (AUD)), and medications (Table 1)
Summary
Standardization and harmonization of healthcare resource utilization data can improve evaluations of the economic impact of treating people with substance use disorder (SUD), including reductions in use of expensive hospital and emergency department (ED) services, and can ensure consistency with current costeffectiveness and cost-benefit analysis guidelines. Economic evaluation is a critical tool to determine the value of substance use disorder (SUD) treatment. In the U.S, annual economic costs for opioid use disorder (OUD) alone are estimated at $787 billion, of which $89 billion represent healthcare resource utilization costs [2]. Reducing highcost healthcare resource utilization is an important positive externality associated with effectively treating SUD that can generate significant savings to the healthcare sector. According to conservative estimates, $1 invested in SUD treatment yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft [3]. When savings to the healthcare sector are taken into account, total savings can exceed costs by a ratio of 12 to 1 [3]
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