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An investigation of scale effects in family substance abuse treatment programs.

Lee AJ - Subst Abuse Treat Prev Policy (2010)

Bottom Line: This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point.In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model.The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Community Health and Sustainability, School of Health and Environment, University of Massachusetts Lowell, 300 Weed Hall, 3 Solomont Way Lowell, MA 01854, USA. AJames_Lee@uml.edu

ABSTRACT
This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families) was too small to be economical. Although the sample size (just nine programs) was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's) Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW) Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

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Related in: MedlinePlus

Plot of Cost per Family-Day Vs. Daily Family Census. Residential Women and Children (RWC) Programs, 1997 (N = 20)
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Figure 3: Plot of Cost per Family-Day Vs. Daily Family Census. Residential Women and Children (RWC) Programs, 1997 (N = 20)

Mentions: The RWC-PPW Demonstration data were re-analyzed, focusing on the relationship between cost per family-day and estimated average family census. This relationship is depicted in Figure 3 for the 20 RWC programs with a daily family census of 30 or less in 1997. It was thought unlikely that anyone in Massachusetts would choose to develop a program with capacity for more than 30 families. A simple linear regression model accounts for approximately one-third of the variance in cost per family day, and the family census variable is significant at the 0.01 level. The data clearly indicate scale effects. Although the sample size is too small to fit a non-linear model, the data scatter in Figure 3 nevertheless suggests that scale effects quickly plateau. In particular, for five of the six programs with a family census of approximately 14 or more, the estimated costs per family-day are similar, varying only from $140 to $178 per family-day, and averaging $157. The average cost per family-day for the 14 smaller programs is $255.


An investigation of scale effects in family substance abuse treatment programs.

Lee AJ - Subst Abuse Treat Prev Policy (2010)

Plot of Cost per Family-Day Vs. Daily Family Census. Residential Women and Children (RWC) Programs, 1997 (N = 20)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2909179&req=5

Figure 3: Plot of Cost per Family-Day Vs. Daily Family Census. Residential Women and Children (RWC) Programs, 1997 (N = 20)
Mentions: The RWC-PPW Demonstration data were re-analyzed, focusing on the relationship between cost per family-day and estimated average family census. This relationship is depicted in Figure 3 for the 20 RWC programs with a daily family census of 30 or less in 1997. It was thought unlikely that anyone in Massachusetts would choose to develop a program with capacity for more than 30 families. A simple linear regression model accounts for approximately one-third of the variance in cost per family day, and the family census variable is significant at the 0.01 level. The data clearly indicate scale effects. Although the sample size is too small to fit a non-linear model, the data scatter in Figure 3 nevertheless suggests that scale effects quickly plateau. In particular, for five of the six programs with a family census of approximately 14 or more, the estimated costs per family-day are similar, varying only from $140 to $178 per family-day, and averaging $157. The average cost per family-day for the 14 smaller programs is $255.

Bottom Line: This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point.In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model.The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Community Health and Sustainability, School of Health and Environment, University of Massachusetts Lowell, 300 Weed Hall, 3 Solomont Way Lowell, MA 01854, USA. AJames_Lee@uml.edu

ABSTRACT
This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families) was too small to be economical. Although the sample size (just nine programs) was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's) Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW) Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

Show MeSH
Related in: MedlinePlus