Cost-Effectiveness of Interventions in Emergency Treatment of Alcohol-Involved Youth

The cost of treating alcohol-related injuries in emergency departments adds up, especially when taking into account the counseling and intervention required in some cases. When youth enter the emergency department with a drinking-related problem, medical personnel are especially compelled to counsel them to make more healthy decisions.

Charles J. Neighbors recently led a group of researchers in examining the cost-effectiveness of different types of intervention for youth that enter emergency departments for alcohol-related injuries.

The study was initiated because interventions in the emergency department have been shown to be effective in preventing future youth alcohol involvement, and to reduce future alcohol-related injury. The study modeled the cost-effectiveness of different types of intervention.

The study looked at the cost-effectiveness of a motivational interviewing-based intervention relative to standard card. Standard care is considered offered when brief advice is given to the youth to stop alcohol-related risk behaviors.

The study compared average cost-effectiveness ratios between the two types of interventions. A cost-utility analysis was also completed to look at the incremental cost of motivational interviewing per quality-adjusted life year gained.

The researchers used microcosting methods to estimate the marginal costs of the two types of intervention (motivational interviewing and standard care) in addition to two methods of patient screening: standard questioning by emergency department personnel and a more proactive outreach by counseling staff.

The researchers investigated average cost-effectiveness rations for drinking and driving, injuries, vehicular citations and negative social consequences. The estimates of marginal effect of motivational interviewing in reducing drinking and driving, traffic fatality risk from drinking and driving youth, and national life tables were used to find the societal costs saved per year by motivational interviewing.

These results were compared with those found for standard care. The researchers used national databases to approximate alcohol-attributable traffic fatality risks.

The study found that invention costs per participant were $81 for standard care, $170 for motivational interviewing with standard screening, and $173 for motivational interviewing with proactive screening.

The researchers found that the cost-effectiveness was better for motivational interviewing than standard care across all study outcomes, and that cost-effectiveness was better for men than women.

The results of the study indicate that the benefit of using brief intervention was a good societal investment. The societal cost per quality-adjusted life year of using motivational interviewing was $8,795. The cost of adopting brief intervention was a better investment than the other options available to emergency departments.