Techna Cadet, Katherine S Elkington, Margaret Ryan, Ali Jalali, Gail A Wasserman, Faye S Taxman, Michael L Dennis, Sean M Murphy
{"title":"在缓刑部门实施和维持基于证据的行为健康电子筛查系统的成本。","authors":"Techna Cadet, Katherine S Elkington, Margaret Ryan, Ali Jalali, Gail A Wasserman, Faye S Taxman, Michael L Dennis, Sean M Murphy","doi":"10.1186/s40352-024-00312-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Roughly 50%-75% of youths who have had contact with the juvenile justice system have a mental-health disorder. In 2019, a northeastern state required probation departments to implement an evidence-based behavioral health (BH) screen. e-Connect is a digital clinical decisional support system designed to identify suicide thoughts and behaviors and related BH risk and triage youths based on BH need, then facilitate linkage to care.</p><p><strong>Objective: </strong>To identify the resources and estimate the costs required to implement and sustain e-Connect from probation-department and policymaker perspectives.</p><p><strong>Methods: </strong>Prospective micro-costing analysis conducted concurrently with a rigorous evaluation of e-Connect. Data were collected for 622 youths ages 10-18 via administrative records, study instruments, and semi-structured interviews. Resources/costs were categorized as \"fixed\", \"time-dependent\", or \"variable\". Mean annual costs (per-county and per-screen, by county) were calculated for two intervention phases, \"implementation\" and \"sustainment\". All costs are in 2019 USD.</p><p><strong>Results: </strong>The policymaker-relevant, annualized, mean, per-county start-up and sustainment costs were $18,704 (SD = $14,320) and $13,374 (SD = $13,317), respectively. The per-screen sustainment cost was $115 (SD = $113) across counties, with variation attributed to a combination of a county's behavioral-health needs, and differences in the types of resources utilized as part of their post-screening clinical response.</p><p><strong>Conclusion: </strong>The results of this analysis will inform the decisions of probation departments and their stakeholders, who are interested in implementing an evidence-based behavioral-health screen for youths on probation. Site-level figures will provide important details regarding the resources/costs associated with various implementation and management strategies. Cross-site, per-person averages will provide crucial inputs into budget impact models and cost-effectiveness analyses.</p>","PeriodicalId":37843,"journal":{"name":"Health and Justice","volume":"13 1","pages":"24"},"PeriodicalIF":3.0000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010558/pdf/","citationCount":"0","resultStr":"{\"title\":\"The cost of implementing and sustaining an evidence-based, behavioral-health electronic screening system in probation departments.\",\"authors\":\"Techna Cadet, Katherine S Elkington, Margaret Ryan, Ali Jalali, Gail A Wasserman, Faye S Taxman, Michael L Dennis, Sean M Murphy\",\"doi\":\"10.1186/s40352-024-00312-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Roughly 50%-75% of youths who have had contact with the juvenile justice system have a mental-health disorder. In 2019, a northeastern state required probation departments to implement an evidence-based behavioral health (BH) screen. e-Connect is a digital clinical decisional support system designed to identify suicide thoughts and behaviors and related BH risk and triage youths based on BH need, then facilitate linkage to care.</p><p><strong>Objective: </strong>To identify the resources and estimate the costs required to implement and sustain e-Connect from probation-department and policymaker perspectives.</p><p><strong>Methods: </strong>Prospective micro-costing analysis conducted concurrently with a rigorous evaluation of e-Connect. Data were collected for 622 youths ages 10-18 via administrative records, study instruments, and semi-structured interviews. Resources/costs were categorized as \\\"fixed\\\", \\\"time-dependent\\\", or \\\"variable\\\". Mean annual costs (per-county and per-screen, by county) were calculated for two intervention phases, \\\"implementation\\\" and \\\"sustainment\\\". All costs are in 2019 USD.</p><p><strong>Results: </strong>The policymaker-relevant, annualized, mean, per-county start-up and sustainment costs were $18,704 (SD = $14,320) and $13,374 (SD = $13,317), respectively. The per-screen sustainment cost was $115 (SD = $113) across counties, with variation attributed to a combination of a county's behavioral-health needs, and differences in the types of resources utilized as part of their post-screening clinical response.</p><p><strong>Conclusion: </strong>The results of this analysis will inform the decisions of probation departments and their stakeholders, who are interested in implementing an evidence-based behavioral-health screen for youths on probation. Site-level figures will provide important details regarding the resources/costs associated with various implementation and management strategies. Cross-site, per-person averages will provide crucial inputs into budget impact models and cost-effectiveness analyses.</p>\",\"PeriodicalId\":37843,\"journal\":{\"name\":\"Health and Justice\",\"volume\":\"13 1\",\"pages\":\"24\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-04-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010558/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health and Justice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s40352-024-00312-6\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRIMINOLOGY & PENOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health and Justice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40352-024-00312-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRIMINOLOGY & PENOLOGY","Score":null,"Total":0}
The cost of implementing and sustaining an evidence-based, behavioral-health electronic screening system in probation departments.
Background: Roughly 50%-75% of youths who have had contact with the juvenile justice system have a mental-health disorder. In 2019, a northeastern state required probation departments to implement an evidence-based behavioral health (BH) screen. e-Connect is a digital clinical decisional support system designed to identify suicide thoughts and behaviors and related BH risk and triage youths based on BH need, then facilitate linkage to care.
Objective: To identify the resources and estimate the costs required to implement and sustain e-Connect from probation-department and policymaker perspectives.
Methods: Prospective micro-costing analysis conducted concurrently with a rigorous evaluation of e-Connect. Data were collected for 622 youths ages 10-18 via administrative records, study instruments, and semi-structured interviews. Resources/costs were categorized as "fixed", "time-dependent", or "variable". Mean annual costs (per-county and per-screen, by county) were calculated for two intervention phases, "implementation" and "sustainment". All costs are in 2019 USD.
Results: The policymaker-relevant, annualized, mean, per-county start-up and sustainment costs were $18,704 (SD = $14,320) and $13,374 (SD = $13,317), respectively. The per-screen sustainment cost was $115 (SD = $113) across counties, with variation attributed to a combination of a county's behavioral-health needs, and differences in the types of resources utilized as part of their post-screening clinical response.
Conclusion: The results of this analysis will inform the decisions of probation departments and their stakeholders, who are interested in implementing an evidence-based behavioral-health screen for youths on probation. Site-level figures will provide important details regarding the resources/costs associated with various implementation and management strategies. Cross-site, per-person averages will provide crucial inputs into budget impact models and cost-effectiveness analyses.
期刊介绍：
Health & Justice is open to submissions from public health, criminology and criminal justice, medical science, psychology and clinical sciences, sociology, neuroscience, biology, anthropology and the social sciences, and covers a broad array of research types. It publishes original research, research notes (promising issues that are smaller in scope), commentaries, and translational notes (possible ways of introducing innovations in the justice system). Health & Justice aims to: Present original experimental research on the area of health and well-being of people involved in the adult or juvenile justice system, including people who work in the system; Present meta-analysis or systematic reviews in the area of health and justice for those involved in the justice system; Provide an arena to present new and upcoming scientific issues; Present translational science—the movement of scientific findings into practice including programs, procedures, or strategies; Present implementation science findings to advance the uptake and use of evidence-based practices; and, Present protocols and clinical practice guidelines. As an open access journal, Health & Justice aims for a broad reach, including researchers across many disciplines as well as justice practitioners (e.g. judges, prosecutors, defenders, probation officers, treatment providers, mental health and medical personnel working with justice-involved individuals, etc.). The sections of the journal devoted to translational and implementation sciences are primarily geared to practitioners and justice actors with special attention to the techniques used.
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