A cost-benefit analysis of Wisconsin's screening, brief intervention, and referral to treatment program: adding the employer's perspective.
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OBJECTIVE: A previous cost-benefit analysis found Screening, Brief Intervention, and Referral to Treatment (SBIRT) to be cost-beneficial from a societal perspective. This paper develops a cost-benefit model that includes the employer's perspective by considering the costs of absenteeism and impaired presenteeism due to problem drinking. METHODS: We developed a Monte Carlo simulation model to estimate the costs and benefits of SBIRT implementation to an employer. We first presented the likely costs of problem drinking to a theoretical Wisconsin firm that does not currently provide SBIRT services. We then constructed a cost-benefit model in which the firm funds SBIRT for its employees. The net present value of SBIRT adoption was computed by comparing costs due to problem drinking both with and without the program. RESULTS: When absenteeism and impaired presenteeism costs were considered from the employer's perspective, the net present value of SBIRT adoption was $771 per employee. CONCLUSIONS: We concluded that implementing SBIRT is cost-beneficial from the employer's perspective and recommend that Wisconsin employers consider covering SBIRT services for their employees. (+info)
A simulation model approach to analysis of the business case for eliminating health care disparities.
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Economic analysis of methamphetamine prevention effects and employer costs.
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OBJECTIVE: The goal of this research was to evaluate economically three interventions designed to prevent substance use in general populations of adolescents, specifically focusing on the prevention of methamphetamine use and its subsequent benefits to employers. METHOD: In a randomized, controlled trial, three preventive interventions were delivered to 6th- or 7th-grade youth in 58 Iowa school districts, with 905 of these youth (449 girls) providing follow-up assessments as 12th graders. Intervention conditions included the family-focused Iowa Strengthening Families Program (ISFP), the school-based Life Skills Training (LST) program, and a combined condition of both the Strengthening Families Program: For Parents and Youth 10-14 (SFP10- 14; an ISFP revision) plus LST (LST + SFP10-14). Analyses based on intervention costs, 12th-grade methamphetamine use rates, and methamphetamine- related employer costs yielded estimates of intervention cost, cost-effectiveness, benefit-cost ratio, and net benefit. RESULTS: The ISFP lowered methamphetamine use by 3.9%, cost $25,385 to prevent each case, and had a benefit-cost ratio of 3.84, yielding a net benefit of $2,813 per youth. The LST program reduced methamphetamine use by 2.5%, required $5,122 per prevented case, and had a benefit-cost ratio of 19.04, netting $2,273 per youth. The combined LST + SFP10-14 prevention condition lowered methamphetamine use rates by 1.8%, cost $62,697 to prevent each case, had a benefit-cost ratio of 1.56, and netted $620 per youth. Findings were robust after varying a number of key parameters across a range of plausible values. CONCLUSIONS: Substance use prevention programming is economically feasible, particularly for effective interventions that have lower per person treatment delivery costs. (+info)
Employer-incurred health care costs and productivity losses associated with influenza.
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National industry's interest in colorectal cancer screening programmes.
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The interest of the largest 200 British industries in developing and financing colorectal screening services for employees was determined. A standard questionnaire asked if the company would advertise screening supply names of employees to local hospitals and finance faecal occult blood testing. The reasons for rejection were noted. Eighty-six companies returned the questionnaire (43% response rate) of which 78 firms (39% of the total mailed) were prepared to advertise screening programmes at the workplace. A quarter of the companies were prepared to both advertise and release employee details. Companies willing to participate employed significantly more people (mean of 17,000 employees) than those rejecting screening (mean of 6100 employees, Mann-Whitney U test = 7, P < 0.05). Fifty-nine industries would consider financing screening, although only five made a definite decision to do so. All companies rejecting (36/36) were concerned about releasing employee information to hospitals. If screening does reduce mortality and community programmes are developed industry could and is prepared to advertise such programmes. If a partnership between hospitals and industry is developed, concerns about employee confidentiality needs to be addressed. (+info)
Making a case for employer-enforced individual mandates.
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An employer-enforced individual mandate has some substantial advantages over the mixed employer and individual mandate embodied in the Clinton administration's proposed health plan. Economic reasoning strongly suggests that almost all of the cost of an employer mandate will fall on workers and that in any case the incidence of an individual mandate is the same as that of an employer mandate. However, an individual mandate is easier for voters to understand, avoids administrative complexities and inequities, and eliminates the chance of adverse employment effects of mandated employer coverage. (+info)