Cost Savings from Alcohol Intervention for Trauma Patients

Brief
alcohol interventions for injured patients in emergency
departments and inpatient trauma services can decrease
future alcohol intake and repeat injuries. To estimate
the cost effectiveness of broadly implementing alcohol
screening and intervention for these patients, researchers
used published data and a decision-analysis model that
simulated cost-benefit scenarios under a variety of conditions.
Findings from the model include the following:

• Twenty-seven percent of
  injured adults treated in an emergency department (representing
  5.5 million visits per year in the United States) would
  be candidates for an alcohol intervention.
• Under baseline model assumptions
  (e.g., for implementation costs, injury rates), each
  $1 spent on alcohol screening and intervention for trauma
  patients would save $3.81 in future direct healthcare
  costs. This corresponds to a net cost savings of $89
  per patient screened or $1.82 billion in direct healthcare
  costs each year.
• When model assumptions
  were allowed to vary, screening and intervention remained
  cost saving in 92% of simulations.

Comments:

The
consistent finding of cost savings over a wide range of
conditions lessens concerns raised by the uncertainties
in the researchers’ baseline assumptions (e.g., high efficacy
of intervention, low cost of screening) and decision-analysis
model (e.g., lack of consideration for false-positive
and false-negative screening results). This well-done
analysis lends support to broader implementation and funding
for alcohol screening and intervention efforts in emergency
departments and trauma services.

Kevin L. Kraemer, MD, MSc

Reference:

Gentilello
LM, Ebel BE, Wickizer TM, et al. Alcohol interventions
for trauma patients treated in emergency departments and
hospitals: a cost-benefit analysis. Ann Surg.
2005;241(4):541-550.