Alcohol advice in primary health care--is it a wise use of resources?
Many attempts to calculate costs caused by the use of alcohol in accordance with the cost-of-illness method have been reported in the literature. However, in a decision-making perspective and with a focus on what possible interventions to undertake, cost-benefit or cost-effectiveness studies are more useful. In this study the cost-effectiveness of advice aimed at reducing 'heavy' drinking to 'moderate' drinking is calculated. Results from controlled trials, showing the short-range effects of advice, are combined with observations from long-term epidemiological studies showing the association between alcohol consumption and total mortality. This study shows that advice from primary health care staff has a potential to be a very cost-effective means of intervention. The crucial point seems to be the number of people that makes durable changes in consumption. If about 1% make lasting changes a brief intervention is relatively cost-effective (20,000 ECU/YLS), and if about 10% change resources will be saved in health care. Important effects such as increased quality of life and decreasing production losses are not taken into account.
Lindholm
L
L
Umeå University, Sweden. Lars.Lindholm@epih.umu.se
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000401:mortality / Q000517:prevention & control*; D015331:Cohort Studies; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D015276:Health Care Rationing / Q000191:economics*; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D011788:Quality of Life; D013548:Sweden / Q000453:epidemiology