7
Regular article Cost estimation when time and resources are limited: The Brief DATCAP Michael T. French a, *, M. Christopher Roebuck b , A. Thomas McLellan c a Department of Sociology, University of Miami, Coral Gables, FL, USA b Caremark, Hunt Valley, MD, USA c Treatment Research Institute, Philadelphia, PA, USA Received 17 November 2003; received in revised form 26 May 2004; accepted 1 July 2004 Abstract The Drug Abuse Treatment Cost Analysis Program (DATCAP) was designed in the early 1990s as a research guide to collect and analyze 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, & McCoy, 2002; French, McCollister, Cacciola, Durell, & Stephens, 2002; French, McCollister, Sacks, McKendrick, & DeLeon, 2002; French et al., 2003; French, Salome ´, & 0740-5472/04/$ – see front matter D 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.jsat.2004.07.001 * Corresponding author. University of Miami, Department of Sociol- ogy, 5202 University Drive, Merrick Building, Room 121F, P.O. Box 248162, Coral Gables, FL 33124-2030, USA. Tel.: +1 305 284 6039; fax: +1 305 284 5310. E-mail address: [email protected] (M.T. French). Journal of Substance Abuse Treatment 27 (2004) 187 – 193

Cost estimation when time and resources are limited: The Brief DATCAP

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    Cacciola, Durell, &

    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: [email protected] (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.

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    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