MEASURING FOR SUCCESS:

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MEASURING FOR SUCCESS

• Determining the Value of Alcohol/Drug Services.

Western Governors Association Presented
by Kenneth D. Stark Division of Alcohol and
Substance Abuse State of Washington June 5, 2001
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WHAT TO MEASURE
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Output Efficiency Measures

• Service Units ( of .)
• Unit Costs
• Utilization Rates

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Outcome Effectiveness Measures

• Prevention
• Knowledge drug effects
• Attitude perceived harm from use
• Behavior last 30 use

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• Treatment
• Alcohol/drug use
• Detox or treatment readmissions
• Criminal justice arrests, convictions,
  incarcerations
• Health care utilization birth outcomes,
  emergency rooms contacts, hospitalizations
• Living arrangements shelter, streets, apartment
• School participation/performance suspensions,
  drop out, grades
• Income public assistance, employed

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• Consumer Satisfaction
• Treated with respect
• Needs were met
• Life improved
• Would recommend to others

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WHEN TO MEASURE
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• Pre-Intervention
• During Intervention
• Completion of Intervention
• Post Intervention

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HOW TO MEASURE
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• Survey self report
• Mail (low cost low response rate)
• Telephone (higher cost higher response rate)
• Face to face (most expensive best response rate)

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• Challenges
• Need releases (clients)
• Need instruments
• Need trained interviewers
• Need current names, addresses, telephone numbers
• Provider workload

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• Secondary data analysisdatabase merging
• Identify other databases
• Extract their data (based on your client list)
• Merge data into new database

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• Possible state databases

• Birth records
• Death records
• MMIS (medicaid)
• Hospital records
• Mental health
• Public Assistance

• Arrests
• Incarcerations
• Employment/earnings
• Child Protective Service
• Child support payments
• School records

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• Challenges
• Need accurate client identifiers
• Need access to other agency records
• Need computer techies
• Do not need client releases, instruments,
  interviewers, provider participation

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SELECT STUDIES

• Birth Outcomes (Medicaid pregnant women)
• Employment/Earnings (All adults in public
  treatment)
• Medical/Psychiatric Costs (indigent
  unemployable/co-occurring mental health)
• Medical (SSI clients)

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• Birth Outcomes
• Mothers treated prenatally compared to untreated
  mothers
• 1/3 less low birthweight (
• 50 less very low birthweight (
• 2/3 lower fetal death rate
• Lower infant medical costs in first two years
  (3,694 vs. 5,447)

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• Employment/Earnings
• Treatment completers consistently show higher
  post treatment employment levels and earnings as
  do treatment non-completers and the no treatment
  group

Employed Monthly Earnings

• Treatment completers 50 1,055.79
• Treatment Non-Completers 38 747.78
• No Treatment 33 754.16

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• Medical
• Treatment group averaged 4,500 less medical
  costs per client over five years than non-treated
  group
• Treated group averaged 7,900 less medical costs
  per client over five years than non-treated group
  (clients all had pre-intervention medical
  expenses)
• 774 savings in medicaid budget per month per SSI
  client treated compared to non-treated SSI
  clients. Savings is after accounting for cost of
  treatment. Treating 480 SSI clients per year
  would save medicaid budget 4.5 million.

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• Psychiatric
• 1.1 million reduction in medicaid costs one year
  after alcohol/drug involuntary treatment compared
  to year prior. Majority of cost savings in
  inpatient psychiatric.
• 2.2 million reduction in medicaid costs one year
  after residential treatment for co-occurring
  substance abuse mental illness compared to year
  prior. Majority of savings in inpatient
  psychiatric.