Abstract
ObjectivesTo estimate the impacts and social value relative to the cost of the Integrated Management of Alcohol Intervention Program in the Health Care System (i-MAP) on direct beneficiaries, using a Social Return on Investment (SROI) analysis.MethodA mixed-method approach was conducted among stakeholders and 113 drinkers (29 low-risk, 43 high-risk, and 41 dependent drinkers) who consecutively received i-MAP at four community hospitals in Songkhla province of Thailand. Resources for program implementation as well as drinking and a list of psychosocial outcomes, selected through stakeholder interviews, were measured among participants during and at the sixth month after participation, respectively. SROI (societal benefit-to-cost) ratio of i-MAP was estimated over a 5-year time horizon and shown in 2017 Thai baht, where US$1.00 = 33.1 baht. One-way and probabilistic sensitivity analyses of key parameters were performed among treatment subgroups.ResultsBaseline estimates of the annual cost and 5-year social value of i-MAP were 25.5 and 51.0 million baht, respectively, yielding an estimated SROI ratio of 2.0, with a possible range of 1.3 to 2.4. Value created by the program was mostly attributed to broader gains to society (productivity gains and averted crime costs) and drinkers. Subgroup analyses suggested that the SROI ratio for high-risk drinkers was twice that for dependent drinkers (2.8 vs. 1.5). The probabilistic sensitivity analysis showed that more than 99% of the simulated treatments for both high-risk and dependent groups yielded benefits beyond the corresponding costs.ConclusionsBy considering societal perspective, the i-MAP program has demonstrated its social value is twice its investment cost and potential for the program to be implemented nationwide.
Highlights
Society suffers from alcohol-related diseases, injuries and mortality [1,2,3] which account for a substantial burden of disease and economic losses among middle-income countries [3]
Subgroup analyses suggested that the Social Return on Investment (SROI) ratio for high-risk drinkers was twice that for dependent drinkers (2.8 vs. 1.5)
The results presented and their interpretation are the authors’, and do not necessarily represent the views of the CAS, the Thai Health Promotion Foundation or Prince of Songkla University
Summary
Society suffers from alcohol-related diseases, injuries and mortality [1,2,3] which account for a substantial burden of disease and economic losses among middle-income countries [3]. In Thailand, the social cost of alcohol consumption was estimated at 156 billion baht in 2006 (US$5 billion), representing 2% of the gross domestic product [4]. This could be an underestimation as plenty of intangible costs, such as societal concerns, domestic violence, caregiver stress and psychological suffering even among problem drinkers themselves [5,6,7,8,9], were not explicitly measured. In Thailand, the Integrated Management of Alcohol Intervention Programs in the Health Care System (i-MAP) was initiated by the Thai Health Promotion Foundation (Thaihealth) in 2011 to provide a comprehensive care process targeting different levels of alcohol users who receive general healthcare services. Due to everyone’s workload, questions regarding the feasibility and worthiness of fully devoting their time to the program were pointed out [12]
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