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Journal of Substance Abuse Treatmenogy, 5202 University Drive, Merrick Building, Room 121F, P.O. Box
248162, Coral Gables, FL 33124-2030, USA. Tel.: +1 305 284 6039; fax:financial data from addiction treatment programs. The addiction research community could clearly benefit from a version of the DATCAP
that reduced the time and effort required for its administration without compromising the integrity of its cost estimates. This paper introduces
the Brief DATCAP and presents some preliminary findings. Initial feedback from respondents suggests that the Brief DATCAP is
understandable, and easier and quicker to complete than the DATCAP. More importantly, preliminary results indicate that cost estimates from
the Brief DATCAP differ from those of the longer DATCAP by less than 2%. These results have important research and policy implications
because a shorter yet reasonably accurate cost instrument will enhance the feasibility and precision of future economic evaluations of
addiction interventions. D 2004 Elsevier Inc. All rights reserved.
Keywords: Cost; Economics; Brief DATCAP
1. Introduction
The foundation of the economic evaluation of any
addiction treatment is a cost analysis of the services that
define that treatment. A proper economic cost analysis is
required to examine cost-effectiveness as well as the net
benefits of alternative treatments or interventions. Unlike the
outcomes side of program evaluation, instrument develop-
ment has emerged only recently for cost analyses. Indeed,
despite the use of various cost instruments in some evalua-
tion studies (e.g., Anderson, Bowland, Cartwright, & Basin,
1998; Barnett, Zaric, & Brandeau, 2001; Capital Consulting
Corporation, 1998; Cisler, Holder, Langabaugh, Stout, &
Zweben, 1998), the Drug Abuse Treatment Cost Analysis
Program (DATCAP) is the only cost instrument that has
undergone extensive testing, regular updates, and peer
review (Alexandre, Roebuck, French, & Barry, 2003; Brad-
ley, French, & Rachal, 1994; Bray, French, Bowland, &
Dunlap, 1996; French & McGeary, 1997; French, Bradley,
Calingaert, Dennis, & Karuntzos, 1994; French, Dunlap,
Galinis, Rachal, & Zarkin, 1996; French, Dunlap, Zarkin,
& Karuntzos, 1998; French, Dunlap, Zarkin, McGeary, &
McLellan, 1997; French, Roebuck, et al., 2002; French,
Sacks, DeLeon, Staines, & McKendrick, 1999; McCollister
& French, 2002; McGeary, French, Sacks, McKendrick, &
DeLeon, 2000; Roebuck, French, &McLellan, 2003; Salome
& French, 2001; www.DATCAP.com). In addition to tra-
ditional cost analyses, the DATCAP has also been used
along with other instruments to perform more advanced eco-
nomic evaluations, including cost-effectiveness analysis and
benefit-cost analysis (Alexandre, Salome, French, Rivers,* Corresponding author. University of Miami, Department of Sociol-Cost estimation when tim
The Brie
Michael T. Frencha,*, M. ChristopaDepartment of Sociology, Univer
bCaremark, HucTreatment Research Ins
Received 17 November 2003; received in r
Abstract
The Drug Abuse Treatment Cost Analysis Program (DATCAP) w0740-5472/04/$ see front matter D 2004 Elsevier Inc. All rights reserved.
doi:10.1016/j.jsat.2004.07.001
+1 305 284 5310
E-mail address: mfrench@miami.edu (M.T. French).rticle
nd resources are limited:
ATCAP
Roebuckb, A. Thomas McLellanc
f Miami, Coral Gables, FL, USA
lley, MD, USA
Philadelphia, PA, USA
form 26 May 2004; accepted 1 July 2004
esigned in the early 1990s as a research guide to collect and analyze
t 27 (2004) 187193acks, McKendrick,& McCoy, 2002; French, McCollister,
Stephens, 2002; French, McCollister, S.
& DeLeon, 2002; French et al., 2003; French, Salome, &
economic cost analysis (Drummond, OBrien, Stoddart, &
anceTorrance, 1997; Gold, Siegel, Russell, & Weinstein, 1996)
and has performed well in numerous evaluation studies, re-
cent information indicates that modifications are necessary
for some applications. At 26 pages, the instrument is some-
what overwhelming for addiction program administrators
who may have little or no familiarity with economic analysis.
Many of these individuals are further discouraged by the
increasing programmatic demands on their time and the
shortage of support staff. Even with a fairly large cash
incentive (e.g., $500), it has become increasingly difficult to
enlist the support of program directors for a cost analysis
employing the DATCAP. The primary reason for declining to
participate was not a lack of interest or data sensitivity con-
cerns, but a lack of available time to complete the DATCAP.
Another concern with administration of the DATCAP at
multiple programs is facilitator burden. As stated in the
DATCAP UserTs Manual (French, 2002b), it is stronglyrecommended that an economist or similarly trained
professional direct the data collection and analysis through
a site visit and ongoing communication such as conference
calls, emails, and telephone conversations. These activities
can easily amount to 3 days or more if treatment admin-
istrators require extensive assistance to assemble data and
comprehend the various measures and related economics
principles of the questionnaire. A shorter instrument that is
easier to understand and complete will certainly reduce the
burden placed on the economist facilitator.
Despite the obvious advantages of a shorter and simpli-
fied DATCAP, such a pursuit would be futile if the resulting
data were incomplete and/or misreported, leading to biased
cost estimates. To investigate the feasibility, burden, and
precision of a Brief DATCAP, we pilot tested the instrument
at five substance abuse treatment programs. The programs
were not selected randomly, but they do represent a range of
different substance abuse interventions, settings, and clients.
In addition, three of the five programs completed both the
DATCAP and Brief DATCAP, which allowed us to assess
any differences in cost estimates between the two instru-
ments. Ultimately, we anticipate that this research project
will lead to a cost estimation instrument that is more
accommodating to program and clinical personnel without
sacrificing economic estimation objectives.
2. Treatment cost estimation
2.1. DATCAP history
The DATCAP was created and launched in the earlyCarney, 2002; French, Salome, Sindelar, Krupski, McKay,
Donovan, McLellan, & Durell, 2000; French, Salome, Sin-
delar, et al., 2002; McCollister, French, Prendergast, et al.,
2003; McCollister, French, Inciardi, et al., 2003).
Although the DATCAP conforms to the principles of
M.T. French et al. / Journal of Subst1881990s (Bradley et al, 1994; French et al., 1994) and hassince undergone extensive revisions. Currently, the eighth
edition of both the DATCAP Program Version (French,
2002a) and the DATCAP UserTs Manual (French, 2002b)can be downloaded in Adobe Acrobat format (.pdf) from
www.DATCAP.com or requested by mail. In addition to the
recently created Brief DATCAP, a Client DATCAP was
also developed to calculate the cost of treatment incurred
by clients (Salome, French, Miller, & McLellan, 2003).
Preliminary versions of these instruments are also available
on the website or by written request. The DATCAP in-
struments are in the public domain, but it is recommended
that an experienced economist administer them.
The DATCAP is a data collection instrument and
interview guide designed to estimate the costs of a substance
abuse treatment program, defined as a single intervention
(i.e., a facility offering both outpatient and inpatient
treatment services would require the completion of two
DATCAPs). Based upon standard accounting and economic
principles, the instrument measures both accounting and
economic costs. Accounting costs represent the actual ex-
penditures of a treatment program and the depreciation of
its resources. Economic costs represent the full value of all
resources (i.e., opportunity costs), regardless of whether a
direct expenditure is involved. In general, economic costs
are equal to accounting costs plus the incremental value of
those resources that are either partially subsidized or used
free of charge by the treatment program (French, 2002b).
The DATCAP is appropriate for economic cost estimation
of most treatment modalities in most social service settings.
The instrument is intended to collect and organize detailed
information on resources used in service delivery and their
associated costs. Resource categories include personnel,
contracted services, buildings and facilities, equipment,
supplies and materials, and miscellaneous items. Addition-
ally, the DATCAP gathers data on program revenues and
client caseflows.
2.2. DATCAP administration
Administration of the DATCAP is generally a collabo-
rative effort involving an economist and various members
of the treatment programTs staff (e.g., administrators,therapist coordinators, and accounting/finance personnel).
The process begins by issuing DATCAP materials to
program personnel who are most familiar with the
operations and financing of the facility. After these person-
nel have had adequate time to review the materials, several
conference calls are conducted between them and the
DATCAP-trained health economists to formulate strategies
for preliminary data collection and to answer questions
regarding the completion of the DATCAP. Generally, pro-
gram personnel are offered guidance about the type and
source of information to gather for administration of the
DATCAP. Besides the familiar categories of program per-
sonnel, equipment, and facilities, indirect costs such as sup-
Abuse Treatment 27 (2004) 187193port personnel, services, contractors, and shared equipment
anceare emphasized. The proper inclusion of these items is
critical for the accuracy of the resource use and cost esti-
mates. A site visit/tour is then conducted by the DATCAP
administrator, during which face-to-face meetings are held
and the instrument is completed. The purpose of the site
visit is to ensure that certain important elements associated
with the operation and financing of the treatment program
are not inadvertently overlooked by either the provider or
the researchers.
2.3. Data assembly procedures
As DATCAP interviews are completed, the resulting data
are entered into a supplementary Microsoft Excel spread-
sheet template that mirrors the hard copy version of the
instrument. This spreadsheet generates a two-page Results
Summary Report, which provides the analysts and the
program director with key statistics from the cost evalua-
tion, including total annual economic cost for the program,
weekly economic cost per client, and total economic cost
per treatment episode.
2.4. Elements of the Brief DATCAP
One of the top priorities in the creation of the Brief
DATCAP was to retain the key elements of the DATCAP.
That is, the Brief DATCAP needed to be structured along
the same resource categories, to produce an identical two-
page Results Summary Report through a corresponding
spreadsheet program, and to include a UserTs Manual toanswer any questions and generally to assist program
personnel. In addition to these features, we also developed
an electronic version of the Brief DATCAP, giving
respondents the option of entering all information directly
from a personal computer rather than on a hard copy of the
instrument. This enhancement assists both program person-
nel and the DATCAP administrators by improving the
efficiency and clarity of data entry.
Regarding the specific changes from the DATCAP to the
Brief DATCAP, some were cosmetic or editorial in nature
while others were more substantive. The list below
summarizes all changes made, organized by sections of
the instrument.
2.4.1. Section A: Program Revenue
All of the program revenue questions were deleted.
This information is useful for describing the financial
operations of the program, but it is not necessary for
cost estimation.
2.4.2. Section B: Client Information
bAverage client-to-counselor/therapist caseload (ratio)Qwas deleted. This question is not necessary for cost
estimation.
Client information is requested for the current fiscal year
M.T. French et al. / Journal of Substonly instead of the current, prior, and next fiscal years.2.4.3. Section C: Personnel
Total cost of employee benefits is now requested in the
aggregate rather than by individual benefit categories (e.g.,
FICA, health insurance, etc.).
2.4.4. Section D: Contracted Services
No changes were made to this section.
2.4.5. Section E: Buildings and Facilities
Questions about the use of buildings and facilities during
the previous and next fiscal years were deleted.
Questions about specific uses of the buildings and
facilities were deleted.
Questions about the annual lease/rental price per square
foot and the estimated fair market value per square foot were
combined into one question. A total of 11 questions in this
section was reduced to 5.
The number of pages in the instrument was reduced
considerably by removing extra copies of the Buildings and
Facilities section and requesting that the respondent make
additional copies of this section for each building/facility
operated by the program.
2.4.6. Section F: Equipment
All detailed and lengthy questions about the units of
equipment by category (i.e., office, computers, electronic,
medical, recreational, child care, residential, vehicles,
miscellaneous), purchase price, purchase year, and condition
were deleted. A single replacement question was added
pertaining to depreciation expenses for all equipment.
2.4.7. Section G: Supplies and Materials
Rather than asking for the cost of supplies and materials
for narrow categories (e.g., medical, office, housekeeping),
a single question now asks about the aggregated cost for all
supplies and materials.
A similar change was executed for the estimated market
value (cost) of supplies and materials used by the treatment
program free of charge.
2.4.8. Section H: Miscellaneous Resources and Costs
No changes in this section.
2.4.9. Section I: Resources and Costs Not
Recorded Elsewhere
This section was eliminated because past administrations
of the DATCAP indicated that very few programs entered
information in this section.
Although these changes to the DATCAP may seem
abundant, it is important to note that the sections and
questions that were preserved in the Brief DATCAP
represent the vast majority of costs at most programs.
For example, Sections C, D, E, and H were retained in
their original form or with minor changes. Summary
statistics from 85 completed DATCAPs (Roebuck et al.,
Abuse Treatment 27 (2004) 187193 1892003) reveal that these sections in most cases comprise
over 90% of the total annual cost of treatment. Thus, it
is unlikely that the Brief DATCAP will significantly alter
the estimated cost of addiction treatment derived from
the DATCAP.
2.5. Description of programs and clients
As noted earlier, program selection for this pilot study
was conducted purposely, based largely on the timing of
ongoing research projects. Nevertheless, the programs
represent a range of outpatient services for both adult and
adolescent treatment clients. Each of the five participating
programs is described below, but the descriptions are kept
fairly general to preserve program anonymity.
Program 1 is an intensive outpatient program for
adolescent treatment clients. It is located in the Southeastern
U.S., and its financial structure is private, not for profit. In
fiscal year (FY) 2002 it served a total of 15 adolescent
clients. The average daily census was 10.4 clients and the
median length of stay was 29.7 weeks.
Program 2 is also an intensive outpatient program for
adolescent treatment clients. It is located in the Mountain
West U.S., and its financial structure is public. In FY 2002 it
served a total of 44 adolescent clients. The average daily
census was 13.1 clients and the median length of stay was
FY 2002 it served a total of 102 clients. The average daily
census was 46 clients and the median length of stay was
15.4 weeks.
Program 4 is also an outpatient program for both adul
and adolescent treatment clients. It is located in the
Midwestern U.S., and its financial structure is private, no
for profit. In FY 2002 it served a total of 29 clients. The
average daily census was 7.6 clients and the median length
of stay was 10.8 weeks.
Program 5 is an adolescent outpatient program located in
the Southwestern U.S., and its financial structure is public
In FY 2002 it served a total of 38 clients. The average daily
census was 8.5 clients and the median length of stay was
12 weeks.
3. Results
Cost data from this pilot study provided financia
information from five separate programs, including three
programs that completed both the DATCAP and the Brief
DATCAP. Although the cost estimates are useful for
demonstrating the feasibility and precision of the Brief
DATCAP, these estimates are not necessarily representative
of all outpatient treatment in the U.S. and thus should not be
(2002
2
15.4 10.8 12.0
69 (0.
43 (0.
37 (0.
16 (0.
92 (0.
17 (0.
73 {$
61 {$
19 {$
Prog
verag
M.T. French et al. / Journal of Substance Abuse Treatment 27 (2004) 18719319015 weeks.
Program 3 is an outpatient program for both adult and
adolescent treatment clients. It is located in the Midwestern
U.S., and its financial structure is public, not for profit. In
Table 1
Comparison of treatment characteristics and costs from the Brief DATCAP
Program 1 Program
Treatment Program Characteristics
Modality AIOP AIOP
Financial structure Private NFP Public
Clients served 15 44
Average daily census 10.4 13.1
Median length of stay (weeks) 29.7 15.0
Treatment Program Costs1
Personnel $184,551 (0.87) $172,3
Contracted services $4,317 (0.02) $14,0
Buildings and facilities $14,021 (0.07) $5,9
Major equipment $0 (0.00) $7,9
Supplies and materials $1,905 (0.01) $13,9
Miscellaneous $7,789 (0.04) $32,5
Brief DATCAP Summary Statistics2
Total annual economic cost $212,583 {$212,583} $246,7
Weekly economic cost per client3 $391 {$391} $3
Economic cost per treatment episode4 $11,603 {$11,603} $5,4
Notes: All costs are reported in 2002 dollars.
AIOP=Adolescent Intensive Outpatient Program; OP=Standard Outpatient1 Proportions of Total Annual Economic Cost reported in parentheses.2 Summary statistics from the DATCAP are reported in braces.3 Weekly Economic Cost per Client = Total Annual Economic Cost / A
4 Economic Cost per Treatment Episode = Weekly Economic Cost per Clien70) $191,199 (0.64) $64,857 (0.81) $84,933 (0.85)
06) $41,492 (0.14) $159 (0.00) $1,472 (0.01)
02) $24,401 (0.08) $1,344 (0.02) $6,504 (0.07)
03) $5,318 (0.02) $160 (0.00) $0 (0.00)
06) $5,828 (0.02) $1,051 (0.01) $3,493 (0.04)
13) $29,560 (0.10) $12,578 (0.16) $3,221 (0.03)
242,583} $297,798 {N/A} $80,150 {N/A} $99,623 {$100,715}
355} $124 {N/A} $202 {N/A} $224 {$226}
5,327} $1,916 {N/A} $2,179 {N/A} $2,688 {$2,718}
ram; AOP=Adolescent Standard Outpatient Program.
e Daily Census / 52.14 weeks.used for any type of policy analysis in this regard. Referring
to Table 1, regardless of service delivery or client
orientation, personnel was the dominant resource category
with over 64% of total annual cost at each of these
dollars)
Program 3 Program 4 Program 5
OP OP AOP
Public Private NFP Public
102 29 38
46.0 7.6 8.5t Median Length of Stay (weeks).t
t
.
l
13.15.673.212.41
ief DA
ance0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Miscellaneous 3.66% 3.66%Supplies and Materials 0.90% 0.90%Major Equipment 0.00% 0.00%Buildings and Facilities 6.60% 6.60%
Brief DATCAP DATCAP BrProgram 1
M.T. French et al. / Journal of Substprograms. The rest of the resource categories had less
consistency in distribution of costs across programs.
Based on the Brief DATCAP data, total annual economic
cost ranged from at $80,150 at Program 4 to $297,798 at
Program 3. At the three programs that also completed the
DATCAP, total annual economic cost was almost identical.
Specifically, compared to the Brief DATCAP, DATCAP
estimates were the same at Program 1, $4,190 lower (1.7%)
at Program 2, and $1,092 higher (1.1%) at Program 5.
Visual comparisons between the DATCAP and Brief
DATCAP data at Programs 1, 2, and 5 are presented in
Fig. 1. This graphic shows the distribution of total annual
cost across the six resource categories using both the
DATCAP and Brief DATCAP instruments. Regardless of
the resource category, these distributions were very similar
for both instruments.
Not surprisingly, weekly economic cost per client was
lower at the standard outpatient programs ($124$224)
relative to the intensive outpatient programs ($361$391).
Similarly, economic cost per treatment episode ranged
between $1,916 and $2,688 for the standard outpatient
programs, and between $5,419 and $11,603 for the
intensive outpatient programs. Again, summary cost sta-
tistics from the DATCAP never displayed more than 2%
variation from the corresponding summary cost statistics
from the Brief DATCAP.
Contracted Services 2.03% 2.03% 5.69Personnel 86.81% 86.81% 69.8
Fig. 1. Comparisons of cost categories for programs com8% 13.28% 0.64% 3.20%% 5.77% 3.60% 3.47%% 1.66% 0.00% 1.08%% 2.45% 6.70% 6.46%
TCAP DATCAP Brief DATCAP DATCAPProgram 2 Program 5Abuse Treatment 27 (2004) 187193 191Although the sample size was relatively small for this
pilot study, it is instructive to report some preliminary
qualitative data as well. Compared to a 23 day full-time
equivalent (FTE) investment for most programs to complete
the DATCAP, the Brief DATCAP required about a 1-day
FTE investment. Input and assistance from an economist
was not measurably different for each instrument, however.
Informal discussion with all five programs that completed
the Brief DATCAP conveyed that the instrument was well
organized and understandable, and the corresponding data
were fairly easy to assemble.
4. Discussion
The DATCAP collects resource use and cost data from
the program perspective and has been utilized in numerous
economic evaluation studies. While practical and expedient
for analyzing a small number of treatment programs with
well-organized data, the administration of the DATCAP
becomes very tedious and expensive when a larger number
of programs are under consideration and/or records are not
ideal or easily accessible. In addition, treatment adminis-
trators have revealed in recent discussions that they have
limited time for discretionary activities such as program
evaluation. For this reason, and in the interest of reducing
% 5.79% 1.52% 1.46%5% 71.06% 87.54% 84.33%
pleting both the DATCAP and the Brief DATCAP.
www.DATCAP.com. While the initial applications of and
Substance Abuse Treatment, 24, 285290.
Alexandre, P. K., Salome, H. J., French, M. T., Rivers, J. E., & McCoy,
York7 Oxford University Press.French, M. T. (2002a). Drug Abuse Treatment Cost Analysis Program
ancepreliminary findings from the Brief DATCAP are encourag-
ing, it is clearly necessary to administer and evaluate the
instrument in more settings, more programs and modalities,
and with different client samples. In addition to variety in
modalities and client mix, further study should make use of
programs of varying size in recognition of the compara-
tively small programs included in the present study. Indeed,
we strongly encourage other researchers to experiment with
the instrument and publish their findings. As with the
DATCAP, we would like to assemble a long list of cost
estimates from a variety of different programs so that the
Brief DATCAP can serve as both a research tool and a
policy aid (see Roebuck et al., 2003).
Given the extensive testing and application of the
DATCAP, one might question the viability of a substitute
instrument such as the Brief DATCAP. History will be the
best judge, but it is our hope and expectation that the Brief
DATCAP will make economic evaluation research more
appealing to addiction treatment programs that may have
been reluctant to complete the DATCAP.
The presence of two cost instruments on the DATCAP
web page occasionally leads respondents to inquire whether
it is best to complete the DATCAP or the Brief DATCAP. If
time and resources permit, we always direct the respondent
to the DATCAP because the methods are sound and the
information can be used for a variety of purposes. But if the
respondent has limited time, resources, and/or detailed
records, then we encourage the use of the Brief DATCAP,
especially if the sole objective is to obtain summary cost
statistics. To expedite the completion of any DATCAP
instrument in the future, we plan to add a Frequently Asked
Questions (FAQ) section to the DATCAP web page and to
have this information easily accessible through a hyperlink
on the main screen.
5. Conclusion
The dual objective of this paper was to launch Edition 1
of the Brief DATCAP and to present pilot study findings
from five addiction programs. A small sample such as this
does not definitively validate or endorse an instrument, but
the results suggest that the Brief DATCAP is easy to under-
stand, agreeable to program directors, and similar to the
DATCAP in summary cost estimates. As with the DATCAP,respondent burden, they have repeatedly expressed a desire
for a shorter version of the DATCAP instrument. Given
these time and resource constraints, the addiction research
community could clearly benefit from a version of the
DATCAP that reduced the time and effort required for its
administration without compromising the integrity of its
cost estimates.
The first edition of the Brief DATCAP is available from
the corresponding author by mail or by download at
M.T. French et al. / Journal of Subst192we hope that other analysts will join us in future appli-(DATCAP): Program version 8. Coral Gables, FL7 University of Miami.Available at www.DATCAP.com.
French, M. T. (2002b). Drug Abuse Treatment Cost Analysis Program
(DATCAP): Program version 8 userTs manual. Coral Gables, FL7C. B. (2002). Consequences and costs of closing a publicly-funded
methadone maintenance clinic. Social Science Quarterly, 83, 519536.
Anderson, D. W., Bowland, B. J., Cartwright, W. S., & Bassin, G. (1998).
Service-level costing of drug abuse treatment. Journal of Substance
Abuse Treatment, 15, 201211.
Barnett, P. G., Zaric, G. S., & Brandeau, M. L. (2001). The cost-
effectiveness of buprenorphine maintenance therapy for opiate addiction
in the U.S. Addiction, 96, 12671278.
Bradley, C. J., French, M. T., & Rachal, J. V. (1994). Financing and cost of
standard and enhanced methadone treatment. Journal of Substance
Abuse Treatment, 11, 433442.
Bray, J. W., French, M. T., Bowland, B. J., & Dunlap, L. J. (1996). The
cost of Employee Assistance Programs (EAPs): Findings from seven
case studies. Employee Assistance Quarterly, 11, 119.
Capital Consulting Corporation. (1998). Measuring the cost of substance
abuse treatment services: An overview. Contract for the Center for
Substance Abuse Treatment, SAMHSA 270-91-8327.
Cisler, R., Holder, H. D., Longabaugh, R., Stout, R. L., & Zweben, A.
(1998). Actual and estimated replication costs for alcohol treatment
modalities: Case study from Project MATCH. Journal of Studies on
Alcohol, 59, 503512.
Drummond, M. F., OBrien, C. P., Stoddart, G. L., & Torrance, G.W. (1997).
Methods for the economic evaluation of health care programmes. Newcations of the Brief DATCAP so that the instrument can be
incrementally improved and widely utilized.
Acknowledgments
Financial assistance for this study was provided by the
National Institute on Drug Abuse (grant numbers 1R01
DA11506 and 3P50 DA07705) and the National Institute
on Alcoholism and Alcohol Abuse (1R01 AA13167). We
are grateful to Jody Sindelar and Silvana Zavala for
helpful suggestions on earlier versions of the Brief
DATCAP; Mark Godley, Michael Boyle, Holly Waldron,
Paula Riggs, Michael Miller, Howard Liddle, Gayle
Dakof, Cindy Rowe, and Craig Henderson for assistance
with data collection, and William Russell and Carmen
Martinez for administrative and editorial assistance. The
authors are entirely responsible for the research conducted
in this paper and their position or opinions do not
necessarily represent those of the National Institute on
Drug Abuse, the National Institute on Alcoholism and
Alcohol Abuse, the University of Miami, Caremark, or the
Treatment Research Institute.
References
Alexandre, P. K., Roebuck, M. C., French, M. T., & Barry, M. (2003). The
cost of residential addiction treatment in public housing. Journal of
Abuse Treatment 27 (2004) 187193University of Miami. Available at www.DATCAP.com.
French, M. T., Bradley, C. J., Calingaert, B., Dennis, M. L., & Karuntzos,
G. T. (1994). Cost analysis of training and employment services in
methadone treatment. Evaluation and Program Planning, 17, 107120.
French, M. T., Dunlap, L. J., Galinis, D. N., Rachal, J. V., & Zarkin, G. A.
(1996). Health care reforms and managed care for substance abuse
services: findings from 11 case studies. Journal of Public Health Policy,
17, 181203.
French, M. T., Dunlap, L. J., Zarkin, G. A., & Karuntzos, G. T. (1998).
The costs of an enhanced employee assistance program (EAP)
intervention. Evaluation and Program Planning, 21, 227236.
French, M. T., Dunlap, L. J., Zarkin, G. A., McGeary, K. A., &McLellan, A.
T. (1997). A structured instrument for estimating the economic cost of
drug abuse treatment: The Drug Abuse Treatment Cost Analysis Pro-
gram (DATCAP). Journal of Substance Abuse Treatment, 14, 445455.
French, M. T., McCollister, K. E., Cacciola, J., Durell, J., & Stephens, R. L.
(2002). Benefit-cost analysis of addiction treatment in Arkansas:
Specialty and standard residential programs for pregnant and parenting
women. Substance Abuse, 23, 3151.
French, M. T., McCollister, K. A., Sacks, S., McKendrick, K., & DeLeon,
G. (2002). Benefit-cost analysis of a modified therapeutic community
for mentally ill chemical abusers. Evaluation and Program Planning,
25, 137148.
French, M. T., & McGeary, K. A. (1997). Estimating the economic cost of
substance abuse treatment. Health Economics, 6, 539544.
French, M. T., Roebuck, M. C., Dennis, M. L., Diamond, G., Godley, S.,
French, M. T., Salome, H. J., Krupski, A., McKay, J. R., Donovan, D. M.,
McLellan, A. T., & Durell, J. (2000). Benefit-cost analysis of residential
and outpatient addiction treatment in the state of Washington.
Evaluation Review, 24, 609634.
French, M. T., Salome, H. J., Sindelar, J. L., & McLellan, A. T. (2002).
Benefit-cost analysis of addiction treatment: Methodological guidelines
and application using the DATCAP and ASI. Health Services Research,
37, 433455.
Gold, M. R., Siegel, J. E., Russell, L. B., & Weinstein, M. C. (1996). Cost-
effectiveness in health and medicine. New York7 Oxford UniversityPress.
McCollister, K. E., & French, M. T. (2002). The economic cost of substance
abuse treatment in criminal justice settings. In C. G. Leukefeld, F. Tims,
& D. Farabee (Eds.), Treatment of drug offenders: Policies and issues
(pp. 2237). New York7 Springer Publishing Company.McCollister, K. E., French, M. T., Inciardi, J. A., Butzin, C. A., Martin, S.
S., & Hooper, R. M. (2003). Post-release substance abuse treatment for
criminal offenders: A cost-effectiveness analysis. Journal of Quantita-
tive Criminology, 19, 389407.
McCollister, K. E., French, M. T., Prendergast, M., Wexler, H., Sacks, S., &
Hall, E. (2003). Is in-prison treatment enough? A cost-effectiveness
analysis of prison-based treatment and aftercare services for substance-
abusing offenders. Law and Policy, 25, 6382.
McGeary, K. A., French, M. T., Sacks, S., McKendrick, K., & DeLeon, G.
(2000). Service use and cost by mentally ill chemical abusers:
Differences by retention in a therapeutic community. Journal of
M.T. French et al. / Journal of Substance Abuse Treatment 27 (2004) 187193 193patient marijuana treatment for adolescents: Findings from a multisite
field experiment. Addiction, 97, 8497.
French, M. T., Roebuck, M. C., Dennis, M. L., Godley, S. H., Liddle, H., &
Tims, F. M. (2003). Outpatient marijuana treatment for adolescents:
Economic evaluation of a multisite field experiment. Evaluation
Review, 27, 421459.
French, M. T., Sacks, S., DeLeon, G., Staines, G., &McKendrick, K. (1999).
Modified therapeutic community for mentally ill chemical abusers:
Outcomes and costs. Evaluation and the Health Professions, 22, 6085.
French, M. T., Salome, H. J., & Carney, M. (2002). Using the DATCAP
and ASI to estimate the costs and benefits of residential addiction
treatment in the state of Washington. Social Science and Medicine, 55,
22672282.Substance Abuse, 11, 115.
Roebuck, M. C., French, M. T., & McLellan, A. T. (2003). DATStats:
Summary results from 85 completed Drug Abuse Treatment Cost
Analysis Programs (DATCAPs). Journal of Substance Abuse Treat-
ment, 25, 5157.
Salome, H. J., & French, M. T. (2001). Using cost and financing
instruments for economic evaluation of substance abuse treatment
services. In M. Galanter (Ed.), Recent developments in alcoholism. Vol.
15: Services research in the era of managed care (Sec. III, Ch. 11, pp.
253269). New York7 Kluwer Academic/Plenum Publishers.Salome, H. J., French, M. T., Miller, M., & McLellan, A. T. (2003).
Estimating the client costs of addiction treatment: First findings from
the client DATCAP. Drug and Alcohol Dependence, 71, 195206.Tims, F., Webb, C., & Herrell, J. (2002). The economic cost of out-
Cost estimation when time and resources are limited: The Brief DATCAPIntroductionTreatment cost estimationDATCAP historyDATCAP administrationData assembly proceduresElements of the Brief DATCAPSection A: Program RevenueSection B: Client InformationSection C: PersonnelSection D: Contracted ServicesSection E: Buildings and FacilitiesSection F: EquipmentSection G: Supplies and MaterialsSection H: Miscellaneous Resources and CostsSection I: Resources and Costs Not Recorded Elsewhere
Description of programs and clients
ResultsDiscussionConclusionAcknowledgmentsReferences
Recommended