Harmonizing healthcare and other resource measures for evaluating economic costs in substance use disorder research

• Type of Material: Article
• Authors: Michelle A. Papp, Weill Cornell Medical College; Jared A. Leff, Weill Cornell Medical College; Sean M. Murphy, Weill Cornell Medical College; April Yang, University of Miami; Heidi M. Crane, University of Washington; Lisa R. Metsch, Columbia University; Carlos del Rio, Emory University; Carlos Del Rio, Emory University; Daniel J. Feaster, University of Miami; Josiah D. Rich, Brown University; Bruce R. Schackman, Weill Cornell Medical College; Kathryn E. McCollister, University of Miami
• Language: English
• Date: 2021-04-08
• Publisher: BMC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © The Author(s). 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13011-021-00356-z
• Title of Journal or Parent Work: Substance Abuse Treatment, Prevention, and Policy
• Volume: 16
• Issue: 1
• Start Page: 32
• End Page: 32
• Grant/Funding Information: This study was supported by the National Institute on Drug Abuse (P30DA040500; R01DA035280; R01DA032098; R01DA030771).
• Keywords: Life Sciences & Biomedicine; Substance Abuse; Economic evaluation; Substance use disorder; Management; Data harmonization; Healthcare resource utilization; Science & Technology
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health; Health Sciences, Health Care Management

Abstract

Background 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 cost-effectiveness and cost-benefit analysis guidelines. Methods We 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. Results We 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. Conclusions We 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. Supplementary Information The online version contains supplementary material available at 10.1186/s13011-021-00356-z.