title: Costs of alcohol screening and brief intervention in medical settings: a review of the literature.
abstract: OBJECTIVE
  This article summarizes the literature on the implementation costs of alcohol screening and brief intervention (SBI) in medical settings.
  
  
  METHODS
  Electronic databases were searched using SBI- and cost-related terms. Methodological approaches and cost estimates were abstracted from each study and categorized based on the cost methodology. Costs were updated to 2009 U.S. dollars. To determine a summary cost measure, we excluded outliers and computed the median of the remaining cost estimates.
  
  
  RESULTS
  Seventeen studies with cost estimates were identified for further study. Costs ranged from $0.51 to $601.50 per screen and from $3.41 to $243.01 per brief intervention (BI). Cost estimates were lower when an activity-based cost methodology was used, in primary care settings, and when the provider was not a doctor. The median summary cost of a screen is approximately $4, and the median summary cost of a BI is approximately $48.
  
  
  CONCLUSIONS
  Screening cost estimates had more variation than BI cost estimates. Provider type and service delivery time drive the cost variation. Interpretation of cost differences was limited by insufficient reporting of the cost methodology. Cost estimates presented here are similar in size to the Healthcare Common Procedure Coding System and Current Procedural Terminology reimbursement amounts, suggesting that insurance-based service reimbursement may be sufficient to sustain alcohol SBI in practice.
authors.affiliation: RTI International, Research Triangle Park, North Carolina. bray@rti.org
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Bray
authors.forename: Gary A
authors.initials: GA
authors.lastname: Zarkin
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Hinde
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mills
mesh_terms: D000437:Alcoholism / Q000191:economics* / Q000628:therapy; D003362:Cost-Benefit Analysis / Q000379:methods / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000191:economics*; D011614:Psychotherapy, Brief / Q000191:economics*; D015813:Substance Abuse Detection / Q000191:economics*; D014481:United States