The cost-effectiveness of brief intervention versus brief treatment of Screening, Brief Intervention and Referral to Treatment (SBIRT) in the United States

Barbosa, Carolina and Cowell, Alexander J. and Dowd, Bill and Landwehr, Justin and Aldridge, Arnie and Bray, Jeremy (2017) The cost-effectiveness of brief intervention versus brief treatment of Screening, Brief Intervention and Referral to Treatment (SBIRT) in the United States. Addiction (Abingdon, England), 112 (Suppl.). pp. 73-81. ISSN 1360-0443

Abstract

AIMS:To conduct a cost-effectiveness analysis (CEA) comparing the delivery of brief intervention (BI) with brief treatment (BT) within Screening, Brief Intervention and Referral to Treatment (SBIRT) programs. DESIGN:Quasi-experimental differences in observed baseline characteristics between BI and BT patients were adjusted using propensity score techniques. Incremental comparison of costs and health outcomes associated with BI and BT. SETTING:Health-care settings in four US states participating in Substance Abuse and Mental Health Services Administration SBIRT grant programs. PARTICIPANTS:Ninety patients who received BT and 878 who received BI. MEASUREMENTS:Per-patient cost of SBIRT, patient demographics and six measures of substance use: proportion using alcohol, proportion using alcohol to intoxication, days of alcohol use, days of alcohol use to intoxication, proportion using drugs and days using drugs. FINDINGS:BI and BT were associated with better outcomes. The cost of SBIRT was significantly higher for BT patients ($75.54 versus 16.32, 95% confidence interval, P