Modelling the costs and outcomes of changing rates of screening for alcohol misuse by GPs in the Australian context.
OBJECTIVE
To assess the relative cost effectiveness of four strategies (academic detailing, computerised reminder systems, target payments and interactive continuing medical education) to increase the provision of screening and brief interventions by Australian GPs with the ultimate goal of decreasing risky alcohol consumption among their patients.


METHODS
This project used a modelling approach to combine information on the effectiveness and costs of four separate strategies to change GP behaviours to estimate their relative cost effectiveness.


RESULTS
The computerised reminder system and academic detailing appear most effective in achieving a decrease in the number of standard drinks consumed by risky drinkers.


CONCLUSIONS
Regardless of the assumptions made, the targeted payment strategy appeared to be the least cost-effective method to achieve a decrease in risky alcohol consumption while the other three strategies appear reasonably comparable.
Shanahan
Marian
M
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia. M.Shanahan@med.unsw.edu.au
Shakeshaft
Anthony
A
Mattick
Richard P
RP
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D001315:Australia / Q000453:epidemiology; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D003376:Counseling / Q000191:economics; D004502:Education, Medical, Continuing / Q000191:economics / Q000379:methods; D005194:Family Practice / Q000193:education / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data*; D008485:Medical Audit / Q000191:economics; D008875:Middle Aged; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015397:Program Evaluation; D017010:Reminder Systems / Q000191:economics; D012309:Risk-Taking