Program evaluation research has a long tradition in health care and many evaluation methods are scientifically advanced and empirically tested. However, program evaluation of substance abuse interventions is a relatively new science, especially regarding estimation of economic costs and benefits. The dearth of both theoretical and empirical economic evaluation studies is particularly unfortunate for substance abuse programs because contemporary funding sources (i.e., insurance companies, managed care organizations, State legislatures, national government, foundations) are demanding that these programs demonstrate positive net benefits. With little guidance on how to conduct or interpret economic analyses, these programs are at a distinct disadvantage for securing competitive health care dollars. Given the great need for economic evaluation studies in the substance abuse literature, the proposed application will complete the following broad aims. 1. Develop and improve scientifically rigorous yet practical economic evaluation methods that can be readily adapted to various types of drug abuse interventions, particularly treatment and prevention programs. 2. Test the practicality and scientific integrity of these economic evaluation methods using data from currently funded drug abuse research studies that do not have a structured or advanced economic analysis component. The proposed study would provide support for the investigators to continue a productive research program on the economics of substance abuse by committing resources to the important task of methods development and testing. The research and policy significance of this application is immediate and widespread. A majority of substance abuse researchers and practitioners are convinced that most structured substance abuse programs/interventions are effective and cost-effective relative to other health (e.g., brief counseling, self-help groups) and non-health (e.g., legal sanctions, coercion programs) alternatives. However, to guarantee their survival in today's health care environment, substance abuse programs/interventions must demonstrate their economic value through rigorous economic analyses that will generate quantitative evidence for clients, public officials, and third-party payers.
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