Los estudios del coste del alcoholismo: marco conceptual, limitaciones y resultados en España Cost of illness studies: conceptual framework, limits and results in Spain

Autores/as

  • Aníbal García-Sempere Antares Consulting. Enviar correspondencia a: Aníbal García-Sempere. Antares Consulting S.A. Vía Augusta, 200 1º sur. 08021 Barcelona.
  • E. Portella Antares Consulting.

DOI:

https://doi.org/10.20882/adicciones.545

Palabras clave:

economía, coste de la enfermedad, alcoholismo, salud pública cost of illness, economy, alcohol abuse, public health

Resumen

Los estudios sobre las consecuencias económicas del alcoholismo utilizan usualmente la metodología de “estudio del coste de la enfermedad”, donde el impacto de un determinado problema de salud sobre el bienestar de la sociedad se valora mediante la cuantificación de los costes de los recursos empleados para su prevención y tratamiento, los costes legales atribuibles, las pérdidas de productividad derivadas de la morbilidad y mortalidad específicas y la pérdida de años de vida ajustados por calidad. En España, y siguiendo esta metodología, se han valorado los costes del alcoholismo en más de 630.000 millones de pesetas anuales. Estos estudios han recibido críticas en relación con la identificación, medida y cuantificación de los costes, y su utilidad es discutida. Sin embargo, y pese a determinadas limitaciones, los estudios del coste de la enfermedad aproximan a la magnitud del problema, contribuyen a identificar los aspectos del problema que suponen un coste más elevado y, ayudan a orientar las políticas. El ajuste a las guías metodológicas y la explicitación detallada de las fuentes y métodos utilizados es un requisito necesario para su credibilidad.
Studies on economic consequences of alcoholism usually use “cost-of-illness studies” methodology, where impact on society’s well-being of a certain problem of health is valued by means of quantifying the costs of resources used for its prevention and treatment, the attributable legal costs, the productivity losses derived from specific morbidity and mortality and the loss of quality adjusted life years. In Spain, and following this methodology, costs of alcoholism have been valued in more than 630,000 annual million pesetas. These studies have received critics in relation to the identification, measurement and quantification of costs, and their utility is been discussed. Nevertheless, and in spite of certain limitations, cost-of-illness studies approximate to the magnitude of the problem, contribute to identify aspects of the problem that suppose a higher cost and help to orient policies. Adjustment to methodology guides and explicit sources and used methods are necessary requirements for its credibility.

Citas

(1) Rice DP. Estimating the Cost of Illness. DHEW Publication (PHS) 947-6. Rockville, MD: U.S. Department of Health, Education and Welfare, 1966.

(2) Maynard A, Hardman G, Whelan A. Measuring the social costs of addictive substances. Br J Addiction 1987; 82:701-706.

(3) Collins DJ, Lapsley HM. Estimating the Economic Costs of Drug Abuse in Australia. National Campaign Against Drug Abuse. Monograph Series 15. Canberra: Australian Government Printing Service, 1991.

(4) Single E, Collins D, Easton B, Harwood H, Lapsley H, Maynard A. International Guidelines for estimating the costs of substance abuse.

Ottawa: Canadian Centre on Substance Abuse, 1996.

(5) Harwood H, Fountain D, Livermore G. The economic costs of alcohol and drug abuse in the United States, 1992. NIH Publication 98-4327. Bethesda, Ma: National Institutes of Health, 1998.

(6) Robson L, Single E. Literature Review of Studies on the Economic Costs of Substance Abuse. Ottawa: Canadian Centre on Substance

Abuse, 1995.

(7) Hodgson TA, Meiners M.Guidelines for Cost of Illness Studies in the Public Health Service. Task Force on Cost of Illness Studies. Washington: U.S. Public Health Service, 1979.

(8) Hodgson TA, Meiners M. Cost-of-Illness Methodology: A Guide to Current Practices and Procedures. Milbank Memorial Fund Quarterly

; 60:429-462.

(9) Harwood H, Napolitano DM, Christensen PL, Collins JJ. Economic Costs to Society of Alcohol and Drug Abuse and Mental Illness: 1980. Research Triangle Park, NC: Research Triangle Institute, 1984.

(10) Rice DP, Hodson TA, Kopstein AN. The economic costs of illness: a replication and update. Health Care Financing Rev 1985; 7:61-80.

(11) Rice DP, Kelman S, Miller LS, Dunmeyer S. The Economic Cost of Alcohol and Drug Abuse and Mental Illness 1985. DHHS Publication 90-

San Francisco: Institute for Health and Aging, University of California, 1990.

(12) DiNardo J. A Critical Review of the Estimates of the “Costs” of Alcohol and Drug Use. Los Angeles, CA: University of California - RAND Corporation, 1992.

(13) Drummond M. Cost-of-illness studies: a major headache? Pharmacoeconomics 1992; 2:1-4.

(14) Heien DM, Pittman DJ. The economic costs of alcohol abuse: an assessment of current methods and estimates. J Studies Alcohol 1989; 50:567-579.

(15) Heien DM, Pittman DJ. The external costs of alcohol abuse. J Studies Alcohol 1993; 54: 302-7.

(16) Estimating costs associated with alcohol abuse: towards a pattern approach. International Center for Alcohol Policies. August 1999.

(17) Koopmanschap MA. Cost-of-illness studies: useful for health policy? Pharmaco-Economics 1998; 14: 143-148.

(18) Wiseman V, Mooney G. Burden of illness estimates for priority setting: a debate revisited. Health Policy 1998; 43: 243-251.

(19) Maynard A, Godfrey C, Hardman G. Conceptual issues in estimating the social costs of alcohol. Ottawa: Canadian Centre on Substance Abuse, 1994.

(20) Reynolds DJ. The Cost of Road Accidents. J Royal Stat Soc 1956; 119:393-408.

(21) Fein R. Economics of Mental Illness. New York: Basic Books, 1958.

(22) Pritchard HM. Economic Costs of Abuse of and Dependency on Alcohol in Australia. In: Kiloh LG, Bell DS, eds. Proceedings of the 29th

International Congress on Alcoholism and Drug Dependence, February 1970. Sydney, Australia: Butterworths, 1971.

(23) Berry R, Boland J. The Economic Costs of Alcohol Abuse - 1972. Brookline, MA: Policy Analysis Inc., 1973.

(24) A.D. Little, Inc. Social Costs of Drug Abuse. Report to the Special Action Office of Drug Abuse Policy. Washington: the White House,

(25) Collins D, Lapsley H. The Social Costs of Drug Abuse in Australia in 1988 and 1992. Camberra: Commonwealth Department of Human Services and Health. Australian Government Publishing Service, 1996.

(26) Single E, Robson L, Xie X, Rehm J. The Costs of Substance Abuse in Canada. Ottawa, Canada: Canadian Centre on Substance Abuse, 1996.

(27) Single E, Robson L, Xie X, Rehm J. The economic costs of alcohol, tobacco and illicit drugs in Canada, 1992. Addiction 1998;93:991-1006.

(28) Xie X, Rehm J, Single E, Robson L, Paul J. The economic costs of alcohol abuse in Ontario.Pharmacol Res 1998;37:241-249.

(29) Devlin NJ, Scuffham PA, Bunt LJ. The social costs of alcohol abuse in New Zealand. Addiction 1997;92:1491-1505.

(30) Nakamura K, Tanaka A, Takano T. The social cost of alcohol abuse in Japan. J Studies Alcohol 1993; 54:618-625.

(31) Rovira J, Oriols P. Aproximació al cost social de l’alcoholisme a Catalunya. Barcelona: Departament de Sanitat i Seguretat Social.

Generalitat de Catalunya, 1982.

(32) González López-Valcárcel B Equidad, superequidad y externalidades financieras: los casos del tabaco y del alcohol. Madrid: Ministerio de Sanidad y Consumo, Asociación de Economía de la salud, 2000.

(33) Aproximación al estudio de los costes sociales del alcoholismo en la Comunidad Autónoma Vasca Bilbao: Departamento de Estudios y

Planificación de la Cámara de Comercio y Navegación de Bilbao.

(34) Portella E, Carrillo E, Ridao M, Ribas E, Ribó C, Salvat M El alcohol y su abuso: impacto socioeconómico. Madrid: Panamericana, 1998.

(35) Portella E, Ridao M, Salvat C, Carrillo C. Costes sanitarios del alcoholismo. Aten Primaria 1998; 22: 279-84.

(36) Cook PJ, Moore MJ. Alcohol. En: Newhouse PJ, Culyer J, eds. Handbook of health economics, 2000.

(37) Melberg HO. The concepts of “cost to society” and “social cost”. Oslo: National Institute for Alcohol and Drug Research, 2000.

(38) Wagstaff A. Government prevention policy and the relevance of cost estimates. Br J Addiction 1987; 82: 461-467.

(39) Shiell A, Gerard K and Donaldson C. Cost of illness studies: an aid to decision making? Health Policy 1987; 8: 317-323.

(40) Hodgson TA. Cost of illness studies: no aid to decision-making? Comments of the second opinion of Sheill et al. Health Policy 1989; 11:

-60.

(41) Godfrey C, Hardman G. Changing the Social Cost of Alcohol. York: Centre for Health Economics, University of York, 1994.

(42) Smith K, Wright K. Informal care and conomical appraisal: a discussion of possible methodological approaches. Health Economics

; 3: 137-8.

(43) Cook PJ. The social costs of drinking. En: The Negative Social Consequences of Alcohol Use. Oslo: Norwegian Ministry of Health and Social Affairs, 1991.

Descargas

Publicado

2002-12-15

Número

Vol. 14 (2002): Especial

Sección

Editorial