Implementation and first-year operating costs of an academic medical center-based syringe services program

Abstract Background Syringe services programs (SSPs) remain highly effective, cost-saving interventions for the prevention of blood-borne infections among people who inject drugs. However, there have been restrictions regarding financial resources allocated to these programs, particularly in the US...

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Autores principales:	Tyler S. Bartholomew, Hardik Patel, Kathryn McCollister, Daniel J. Feaster, Hansel E. Tookes
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cost Syringe services programs Implementation Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/27cd86ad02f7452ea77ba2aed7119165
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spelling	oai:doaj.org-article:27cd86ad02f7452ea77ba2aed71191652021-11-21T12:27:15ZImplementation and first-year operating costs of an academic medical center-based syringe services program10.1186/s12954-021-00563-81477-7517https://doaj.org/article/27cd86ad02f7452ea77ba2aed71191652021-11-01T00:00:00Zhttps://doi.org/10.1186/s12954-021-00563-8https://doaj.org/toc/1477-7517Abstract Background Syringe services programs (SSPs) remain highly effective, cost-saving interventions for the prevention of blood-borne infections among people who inject drugs. However, there have been restrictions regarding financial resources allocated to these programs, particularly in the US South. This study aimed to provide cost data regarding the implementation and first-year operations of an academic-based SSP utilizing fixed and mobile strategies, including the integration of onsite wound care. Methods We conducted a micro-costing study that retrospectively collected detailed resource utilization and unit cost data for both the fixed and mobile SSP strategies, including onsite wound care, from both healthcare and societal perspectives. A three-step approach was used to identify, measure, and value intervention costs, and cost components were categorized into implementation, variable program, and time-dependent costs. Sensitivity analysis was performed to examine the impact of SSP operational changes (i.e., needs-based distribution and opt-out HIV/HCV testing) on the cost-per-participant. Cost data we presented as overall cost and cost-per-participant adjusted to 2017 US dollars. Results A total of 452 and 129 participants enrolled in fixed and mobile SSP services, respectively. The total cost associated with implementation and first year operations for the fixed site was $407,217.22 or $729.72 per participant and $311,625.52 or $2415.70 per participant for the mobile unit. The largest cost component for both modalities was time-dependent costs (personnel and overhead), while intervention materials (syringes, injection equipment, naloxone) were less than 15% of the total program cost. Discussion/conclusion Implementation and operation of new SSP models continue to be low cost compared to treatment for the multitude of harms PWID face without access to evidence-based prevention. Future cost-effectiveness and cost–benefit analyses integrating a comprehensive SSP model within an academic institution, including onsite wound care and other medical services, will provide a more comprehensive understanding of this model, and state-level policy action must be taken to lift the prohibition of state and local funds for the implementation, sustainability, and maintenance of these programs in Florida.Tyler S. BartholomewHardik PatelKathryn McCollisterDaniel J. FeasterHansel E. TookesBMCarticleCostSyringe services programsImplementationPublic aspects of medicineRA1-1270ENHarm Reduction Journal, Vol 18, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cost Syringe services programs Implementation Public aspects of medicine RA1-1270
spellingShingle	Cost Syringe services programs Implementation Public aspects of medicine RA1-1270 Tyler S. Bartholomew Hardik Patel Kathryn McCollister Daniel J. Feaster Hansel E. Tookes Implementation and first-year operating costs of an academic medical center-based syringe services program
description	Abstract Background Syringe services programs (SSPs) remain highly effective, cost-saving interventions for the prevention of blood-borne infections among people who inject drugs. However, there have been restrictions regarding financial resources allocated to these programs, particularly in the US South. This study aimed to provide cost data regarding the implementation and first-year operations of an academic-based SSP utilizing fixed and mobile strategies, including the integration of onsite wound care. Methods We conducted a micro-costing study that retrospectively collected detailed resource utilization and unit cost data for both the fixed and mobile SSP strategies, including onsite wound care, from both healthcare and societal perspectives. A three-step approach was used to identify, measure, and value intervention costs, and cost components were categorized into implementation, variable program, and time-dependent costs. Sensitivity analysis was performed to examine the impact of SSP operational changes (i.e., needs-based distribution and opt-out HIV/HCV testing) on the cost-per-participant. Cost data we presented as overall cost and cost-per-participant adjusted to 2017 US dollars. Results A total of 452 and 129 participants enrolled in fixed and mobile SSP services, respectively. The total cost associated with implementation and first year operations for the fixed site was $407,217.22 or $729.72 per participant and $311,625.52 or $2415.70 per participant for the mobile unit. The largest cost component for both modalities was time-dependent costs (personnel and overhead), while intervention materials (syringes, injection equipment, naloxone) were less than 15% of the total program cost. Discussion/conclusion Implementation and operation of new SSP models continue to be low cost compared to treatment for the multitude of harms PWID face without access to evidence-based prevention. Future cost-effectiveness and cost–benefit analyses integrating a comprehensive SSP model within an academic institution, including onsite wound care and other medical services, will provide a more comprehensive understanding of this model, and state-level policy action must be taken to lift the prohibition of state and local funds for the implementation, sustainability, and maintenance of these programs in Florida.
format	article
author	Tyler S. Bartholomew Hardik Patel Kathryn McCollister Daniel J. Feaster Hansel E. Tookes
author_facet	Tyler S. Bartholomew Hardik Patel Kathryn McCollister Daniel J. Feaster Hansel E. Tookes
author_sort	Tyler S. Bartholomew
title	Implementation and first-year operating costs of an academic medical center-based syringe services program
title_short	Implementation and first-year operating costs of an academic medical center-based syringe services program
title_full	Implementation and first-year operating costs of an academic medical center-based syringe services program
title_fullStr	Implementation and first-year operating costs of an academic medical center-based syringe services program
title_full_unstemmed	Implementation and first-year operating costs of an academic medical center-based syringe services program
title_sort	implementation and first-year operating costs of an academic medical center-based syringe services program
publisher	BMC
publishDate	2021
url	https://doaj.org/article/27cd86ad02f7452ea77ba2aed7119165
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Implementation and first-year operating costs of an academic medical center-based syringe services program

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