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[Cost-efficacy analysis of clinically evaluated therapeutic programs. An expanded withdrawal therapy in alcohol
M Driessen1, C Veltrup, K Junghanns
1Klinik für Psychiatrie, Medizinische Universität zu Lübeck.
Background:
Cost-effectiveness analyses complete clinical evaluation studies and thereby support the a well based estimation of therapy efficiency.
Aim:
A qualified (extended) alcohol withdrawal treatment programme (II), which was previously described and evaluated by face-to-face follow-up studies, was analyzed with regard to cost-effectiveness.
Sample:
57 alcohol-dependent patients, which had undergone programme II, were compared with 37 patients after a medical detoxification programme (I).
Methods:
Health insurance data (number and length of all hospitalizations, days of incapacity to work, days of financial substitution for incapacity to work) were assessed for the five years before and after index therapy and for each year, separately.
Results:
While there were no substantial differences for the time before index therapy, programme II patients were hospitalized after index therapy (i) less frequently (3.5 + 4.4 vs. 7.3 + 11.3 times), (ii) for fewer days (66 + 75 vs. 136 + 167) than programme I patients, and they received financial support for fewer days (67 +/- 73 vs 220 +/- 187 days).
Conclusion:
Considering a somewhat better clinical outcome of programme II vs. programme I patients (14% greater abstinence rate within one year) the significantly lower rates and fewer days of follow-up hospitalisations support a sufficient efficiency of the extended alcohol withdrawal treatment programme.