title: Financial costs of alcoholism treatment programs: a longitudinal and comparative evaluation among four specialized centers.
abstract: BACKGROUND
  Alcoholism is a worldwide problem. Many strategies for alcohol detoxification and relapse prevention exist, but each alcohol treatment center has its own program. The objective of this study was to analyze and compare the financial cost and effectiveness of alcohol treatment programs from inpatient stay to follow-up 1 year later. This was a prospective, open, nonrandomized study of 4 specialized alcohol treatment centers and 267 patients admitted for alcohol detoxification.
  
  
  METHODS
  We recorded all medical and nonmedical interventions related to the program during patient stay in the hospital and every 3 months after discharge for 1 year and recorded the occurrence of alcohol relapse. Financial evaluation was based on the prices of refund from the French national health insurance service.
  
  
  RESULTS
  The mean cost of hospitalization ranged from 1326 euros to 1917 euros(p = 0.001), a variation mainly due to the difference in the length of hospital stay but also to the cost of the inpatient program, routine medical checkups, and drugs administered. The mean cost of 1 year of follow-up per patient ranged from 419 euros to 1704 euros (p = 0.001). The efficiency, corresponding to the money spent to prevent the relapse of one patient during 1 month, was approximately 500 euros/month in three centers and 658 euros in the fourth. However, for a similar efficiency, the effectiveness, assessed by the mean time without relapse, was significantly (p = 0.001) different; center 1, which had the highest total cost, had an effectiveness 1.56 times higher than center 3, which had the lowest cost.
  
  
  CONCLUSIONS
  This work emphasizes the heterogeneity of the costs and effectiveness of alcoholism treatment programs and suggests that research should be conducted to determine which program is the most rational, cost-efficient, and beneficial for patients and the public health office economy.
authors.affiliation: Service d'Hépatogastroentérologie et Alcoologie, Centre Hospitalier Universitaire, Caremeau, Nìmes, France. bnalpas@bsi.fr
authors.forename: B
authors.initials: B
authors.lastname: Nalpas
authors.forename: C
authors.initials: C
authors.lastname: Combescure
authors.forename: B
authors.initials: B
authors.lastname: Pierre
authors.forename: T
authors.initials: T
authors.lastname: Ledent
authors.forename: C
authors.initials: C
authors.lastname: Gillet
authors.forename: D
authors.initials: D
authors.lastname: Playoust
authors.forename: T
authors.initials: T
authors.lastname: Danel
authors.forename: M C
authors.initials: MC
authors.lastname: Bozonnat
authors.forename: S
authors.initials: S
authors.lastname: Martin
authors.forename: J L
authors.initials: JL
authors.lastname: Balmès
authors.forename: J P
authors.initials: JP
authors.lastname: Daurès
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000191:economics* / Q000628:therapy*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016320:Substance Abuse Treatment Centers / Q000191:economics*