title: Evaluating the Impact of Hospital Based Drug and Alcohol Consultation Liaison Services.
abstract: Consultation liaison (CL) services provide direct access to specialist services for support, treatment advice and assistance with the management of a given condition. Alcohol and other drugs (AOD) CL services aim to improve identification and treatment of patients with AOD morbidity. Our objective was to evaluate the costs and consequences of AOD CL services in hospitals in New South Wales, Australia. Patients were surveyed at eight hospitals and problematic AOD use was identified using the Alcohol, Smoking and Substance Involvement Screening Test (n=1615). For consenting participants, medical record data were obtained from 18 months pre- to 12 months post-survey. We used interrupted time series analyses to compare utilization and costs for patients with and without AOD problems and changes over time between those who received AOD CL and similar patients. Approximately 35% of patients surveyed had AOD problems (excluding tobacco) with 7% requiring intensive treatment. Only 24% of patients requiring intensive treatment were treated by AOD CL. Those treated had relative improvements over time in the cost of presentations to emergency departments, emergency admission performance and increased uptake of appropriate pharmaceuticals. The estimated net benefit of AOD CL services was at least AUD$100,000 savings per hospital per year. Expanding AOD CL services to address current unmet need may lead to even greater cost savings for hospitals.
authors.affiliation: Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney; Centre for Social Impact (CSI), UNSW, Australia. Electronic address: r.reeve@unsw.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Reeve
authors.affiliation: Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney.
authors.forename: Sheena
authors.initials: S
authors.lastname: Arora
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), UNSW, Australia.
authors.forename: Kerryn
authors.initials: K
authors.lastname: Butler
authors.affiliation: Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney.
authors.forename: Rosalie
authors.initials: R
authors.lastname: Viney
authors.affiliation: National Drug and Alcohol Research Centre (NDARC), UNSW, Australia.
authors.forename: Lucinda
authors.initials: L
authors.lastname: Burns
authors.affiliation: Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney.
authors.forename: Stephen
authors.initials: S
authors.lastname: Goodall
authors.affiliation: Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney.
authors.forename: Kees
authors.initials: K
authors.lastname: van Gool
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000534:rehabilitation*; D003365:Costs and Cost Analysis; D004636:Emergency Service, Hospital; D005260:Female; D006297:Health Services Accessibility; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D065186:Interrupted Time Series Analysis; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D012017:Referral and Consultation / Q000191:economics; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Alcohol; Consultation liaison; Cost benefit; Cost consequences; Drugs; Evaluation