Citation

French MT, McCollister KE, Sacks S, McKendrick K, De Leon G. Eval. Program Plann. 2002; 25(2): 137-148.

Copyright

(Copyright © 2002, Elsevier Publishing)

DOI

10.1016/S0149-7189(02)00006-X

PMID

unavailable

Abstract

This paper estimates and compares the economic benefits and costs of modified therapeutic community (modified TC) treatment for homeless mentally ill chemical abusers (MICAs) relative to a 'treatment-as-usual' (TAU) comparison group. Data from the period 12 months pre-admission to the modified TC were compared to data from 12 months post-admission across three outcome categories: employment, criminal activity, and utilization of health care services. The economic cost of the average modified TC treatment episode was $20,361. The economic benefit generated by the average modified TC client was $305,273. The incremental economic benefit per modified TC client (relative to TAU) was $273,698, resulting in a net benefit per modified TC client of $253,337 and a benefit-cost ratio of 13:1. Adjusting for extreme outlier observations, the incremental economic benefit estimate was $105,618, net benefit was $85,257, and the benefit-cost ratio was 5.2. These results quantify the potential economic and social advantages of the modified TC approach and highlight the policy implications of modified TC programs for homeless MICAs. This study is the first comprehensive economic evaluation of TC treatment for homeless MICAs; future research can draw from the economic analysis methods outlined here to apply to larger samples, longer follow-up periods, and other treatment settings.