Impact of a new specialist alcohol and drug brief intervention service model integrated into the emergency department: An interrupted time series analysis
Rachel A Elphinston, Marianne Wyder, Dominique De Andrade, Kim‐Huong Nguyen, Alan Gude, Linda Hipper
Objective: To describe and examine the impact of a new specialist drug and alcohol brief intervention team (DABIT) model integrated into the ED on the identification of individuals at risk of future alcohol and other drug (AOD)‐related harm. A cost‐outcome analysis was conducted to assess the impact on costs per referral.
Methods: An interrupted time series analysis examined the changes in number of referrals following the implementation of the DABIT model over 2 years (January 2015–December 2016) within a large 436‐bed public hospital. The primary outcome of interest was the number of AOD‐related referrals per month identified following ED presentations. The independent variables were: time (measured in months), implementation periods (pre‐implementation; a transition period of adjustment during which the new DABIT model of care was developed; post‐implementation period with a fully operational DABIT model); and the number of full‐time equivalent staff per month to account for the increase in labour productivity. In a second time series analysis, the outcome was cost per referral per month.
Results: After controlling for changes in labour productivity, the number of referrals was significantly higher following the implementation of the DABIT model when compared to those during the pre‐implementation and transition periods. Costs were significantly lower following DABIT implementation resulting in $1096 net cost savings per referral.
Conclusions: Integration of a specialist brief intervention AOD model to support ED care may increase uptake of specialist AOD treatment and could be beneficial from an economic efficiency viewpoint.