|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$172||Benefits minus costs||$135|
|Participants||($69)||Benefit to cost ratio||$1.58|
|Others||$93||Chance the program will produce|
|Indirect||$172||benefits greater than the costs||48 %|
|Net program cost||($232)|
|Benefits minus cost||$135|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
Smoking tobacco on a regular basis.
Alcohol use disorder
Clinical diagnosis of alcohol use disorder or symptoms measured on a validated scale.
Illicit drug use disorder
Clinical diagnosis of illicit drug use disorder or symptoms measured on a validated scale. When possible, we exclude cannabis/marijuana use disorder from this outcome.
Hospital admission, for any reason.
Admission to a psychiatric ward or hospital.
Emergency department visits
Whether someone visited the emergency department, or the number of times they visited the emergency department.
Blood pressure in the typical clinical range.
Blood sugar (HbA1c)^
Measure of average blood sugar over 10-12 weeks.
“All-cause mortality,” or the proportion of all deaths in a given population during a specified period of time, regardless of the cause.
Total cholesterol (low-density lipoprotein and high-density lipoprotein).
Primary care visits^
Visit to a primary care physician for any reason.
Obese based on clinical guidelines for adults (body mass index of 30 or higher) or children (body mass index at or above the 95th percentile for children of the same age and sex), as appropriate.
|41||1||435||-0.002||0.194||41||0.000||0.086||43||-0.002||0.992||Click to expand||Click to collapse|
|Detailed Monetary Benefit Estimates Per Participant|
|Affected outcome:||Resulting benefits:1||Benefits accrue to:|
|Regular smoking||Labor market earnings associated with smoking||($59)||($139)||$0||$30||($168)|
|Health care associated with smoking||($17)||($5)||($17)||($8)||($47)|
|Mortality associated with smoking||$0||$0||$0||($4)||($5)|
|Alcohol use disorder||Property loss associated with alcohol abuse or dependence||$0||$0||$0||$0||$0|
|Illicit drug use disorder||Criminal justice system||$0||$0||$0||$0||$0|
|Labor market earnings associated with illicit drug abuse or dependence||$21||$49||$0||($11)||$60|
|Mortality associated with illicit drugs||$6||$15||$0||$172||$194|
|Hospitalization||Health care associated with general hospitalization||$43||$2||$43||$22||$109|
|Hospitalization (psychiatric)||Health care associated with psychiatric hospitalization||$155||$2||$35||$77||$269|
|Emergency department visits||Health care associated with emergency department visits||$22||$6||$33||$11||$72|
|Program cost||Adjustment for deadweight cost of program||$0||$0||$0||($116)||($116)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$217||2014||Present value of net program costs (in 2018 dollars)||($232)|
|Comparison costs||$0||2014||Cost range (+ or -)||20 %|
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
|Benefits Minus Costs Over Time (Cumulative Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in discounted dollars. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
Druss, B.G., Rohrbaugh, R.M., Levinson, C.M., & Rosenheck, R.A. (2001). Integrated medical care for patients with serious psychiatric illness: a randomized trial. Archives of General Psychiatry, 58(9), 861-8.
Friedmann, P.D., Hendrickson, J.C., Gerstein, D.R., Zhang, Z., & Stein, M.D. (2006). Do Mechanisms That Link Addiction Treatment Patients to Primary Care Influence Subsequent Utilization of Emergency and Hospital Care?. Medical Care, 44(1), 8-15.
Kilbourne, A.M., Pirraglia, P.A., Lai, Z., Bauer, M.S., Charns, M.P., Greenwald, D., . . . Yano, E.M. (2011). Quality of general medical care among patients with serious mental illness: does colocation of services matter?. Psychiatric Services, 62(8), 922-928.
Laine, C., Hauck, W.W., & Turner, B.J. (2005). Availability of Medical Care Services in Drug Treatment Clinics Associated with Lower Repeated Emergency Department Use. Medical Care, 43(10), 985-995.
Parthasarathy, S., Mertens, J., Moore, C., & Weisner, C. (2003). Utilization and Cost Impact of Integrating Substance Abuse Treatment and Primary Care. Medical Care, 41(3), 357-367.
Pirraglia, P.A., Kilbourne, A.M., Lai, Z., Friedmann, P.D., & O'Toole, T.P. (2011). Colocated general medical care and preventable hospital admissions for veterans with serious mental illness. Psychiatric Services, 62(5), 554-557.
Saxon, A.J., Malte, C.A., Sloan, K.L., Baer, J.S., Calsyn, D.A., Nichol, P., . . . Kivlahan, D.R. (2006). Randomized Trial of Onsite Versus Referral Primary Medical Care for Veterans in Addictions Treatment. Medical Care, 44(4), 334-342.
Scharf, D.M, Eberhart, N.K., Horvitz-Lennon, M., R. Beckman, Han, B., Lovejoy, S., Pincus, H.A., Burnam, M.A. (2013). Evaluation of the SAMHSA Primary and Behavioral ehalth Care Integration Program: Final report. Rand Corporation. http://aspe.hhs.gov/daltcp/reports/2013/PBHCIfr.shtml
Umbricht-Schneiter, A., Ginn, D.H., Pabst, K.M., & Bigelow, G.E. (1994). Providing medical care to methadone clinic patients: referral vs on-site care. American Journal of Public Health, 84(2), 207-210.
Weisner, C., Mertens, J., Parthasarathy, S., Moore, C., & Lu, Y. (2001). Integrating primary medical care with addiction treatment: A randomized controlled trial. JAMA : The Journal of the American Medical Association, 286(14), 1715-1723.
Willenbring, M.L., & Olson, D.H. (1999). A randomized trial of integrated outpatient treatment for medically ill alcoholic men. Archives of Internal Medicine, 159(16), 1946-1952.
Willenbring, M.L., Olson, D.H., & Bielinski, J. (1995). Integrated Outpatient Treatment for Medically Ill Alcoholic Men: Results from a Quasi-Experimental Study. Journal of Studies on Alcohol, 56(3), 337.