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Biomedical subjects

M T French

Publications and source records attributed to M T French.

At least 37 records · Page 2Linked to original sources
PubMed1997

Factors that influence the use and perceptions of employee assistance programs at six worksites.

Employee assistance programs (EAPs) have gained significant importance in contemporary worksites. This article uses data from 6 case studies to examine several research questions regarding the relationship between worker demographic (e.g., gender, job tenure, and marital status), substance use, and workplace policies and the actual and potential use of the company EAP. Unlike in most of the existing literature, the authors did not find that gender, marital status, or job dissatisfaction are statistically related to actual or potential EAP use at most worksites. However, job tenure and some substance use behaviors were related to actual EAP use in a positive and statistically significant way. Another important finding, underlying the credible integration of EAPs into worksite culture, is the positive and robust relationship between employee trust and confidence in the EAP and actual use. The results of our study both reinforce some long-established principles in the EAP field and encourage further consideration of other beliefs.

Adult↗
PubMed1996

Estimating the dollar value of health outcomes from drug-abuse interventions.

OBJECTIVES: People who abuse drugs suffer from a host of medical problems that impose costs on both the abusers and society as a whole. Drug-abuse treatment and other interventions can help alleviate these medical problems, leading to health status improvements for chronic drug users and reduced social costs. The authors' dual purpose here is to (1) propose a theoretically rigorous yet easy-to-apply methodology for estimating the health-related costs of drug abuse and (2) demonstrate the methodology by estimating the potential dollar value of avoiding adverse health consequences as a result of successful drug-abuse interventions. METHODS: The authors' proposed multiattribute quality-adjusted life year methodology for estimating the value of avoiding morbidity and mortality involves eight steps to be followed sequentially. The framework is based on developing a common unit of well-being (i.e., quality-adjusted life year) that can be applied to all types of health conditions. If all health states can be denominated in this common unit, then the process of valuation is straightforward and consistent across all types of illnesses and diseases. The methodology is relatively inexpensive to execute because the estimation procedures are not complicated technically and the data demands are modest. Also, this approach incorporates elements from several disciplines, including psychology, epidemiology, medicine, and economics. Finally, the proposed methodology is flexible enough to cover a wide range of illnesses and diseases so that consistent and comparable estimates can be generated. RESULTS: The authors estimate the dollar value of avoiding acute hepatitis B, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hypertension, bacterial pneumonia, sexually transmitted diseases, and tuberculosis for a white male aged 32 years. The authors' results illustrate that estimated avoided morbidity values can vary significantly across the range of health consequences associated with drug abuse. At the upper end of the range, the value of avoiding only the morbidity associated with a single case of HIV/AIDS is approximately $157,811 for the period beginning with transmission of HIV, through late-stage HIV and AIDS, and ending just before death. CONCLUSIONS: People who abuse drugs suffer from many medical problems in addition to their addiction. The proposed approach for estimating the dollar value of avoiding adverse health consequences provides policy analysts, evaluators, and researchers a method to calculate theoretically based benefit estimates for use in a benefit-cost analysis of drug-abuse interventions.

Adult↗
PubMed1996

Aiding troubled employees: the prevalence, cost, and characteristics of employee assistance programs in the United States.

OBJECTIVES: Employee assistance programs (EAPs) are job-based programs designed to identify and assist troubled employees. This study determines the prevalence, cost, and characteristics of these programs in the United States by worksite size, industry, and census region. METHODS: A stratified national probability sample of more than 6400 private, nonagricultural US worksites with 50 or more full-time employees was contacted with a computer-assisted telephone interviewing protocol. More than 3200 worksites responded and were eligible, with a response rate of 90%. RESULTS: Approximately 33% of all private, nonagricultural worksites with 50 or more full-time employees currently offer EAP services to their employees, an 8.9% increase over 1985. These programs are more likely to be found in larger worksites and in the communications/utilities/transportation industries. The most popular model is an external provider, and the median annual cost per eligible employee for internal and external programs was $21.83 and $18.09, respectively. CONCLUSIONS: EAPs are becoming a more prevalent point of access to health care for workers with personal problems such as substance abuse, family problems, or emotional distress.

Adult↗
PubMed1996

Health care reforms and managed care for substance abuse services: findings from eleven case studies.

In 1992, the United States spent $820 billion on health care. For the same year, an estimated 15 percent of the U.S. population, approximately 43 million people, were uninsured. As health care costs continue to rise, the number of people able to afford coverage continues to decline. Given these statistics, it is not surprising that concern over health care reform is at the forefront of government policy. Over the past few years, policymakers have faced the challenge of creating a more cost-efficient, universal health care system. Many of the proposed reforms rely heavily on managed care practices and treatment limits to help control costs. The impact of managed care is already apparent in primary health care where private insurers have been using it for years (e.g., HMOs, PPOs). However, its full impact on substance abuse treatment services remains unknown. In this paper, we present the perceptions, opinions, and experiences of eleven drug treatment programs regarding the actual or anticipated effects of managed care and health care reforms on the delivery, financing, and costs of substance abuse treatment. We also present an analysis of these programs' current costs and financing. We believe that the information presented in this paper provides timely insights into the substance abuse treatment system; these insights should assist policymakers in developing optimal health care reform policies.

Cost-Benefit Analysis↗
PubMed1995

Is moderate alcohol use related to wages? Evidence from four worksites.

Moderate alcohol users (approximately two drinks per day on average) have recently been shown to have a lower risk of coronary heart disease relative to abstainers and heavy drinkers. Conversely, a few studies have found that alcoholism is associated with greater unemployment and lower earnings. But, little research has examined the differential effects of drinking levels on job compensation. We utilize a newly created database on employees at four worksites to test for a nonlinear relationship between alcohol use and wages. We also examine whether alcohol use affects wages indirectly through educational achievement, marital status, and poor health. Our findings suggest an inverse U-shaped relationship between alcohol consumption and wages with a peak at approximately 1.5 to 2.5 drinks per day on average. Thus, controlling for other variables and conditional on working, moderate alcohol users have higher wages than abstainers and heavy drinkers at these worksites. We also find evidence that alcohol use is related to wages through human capital variables.

Adult↗
PubMed1995

Economic evaluation of drug abuse treatment programs: methodology and findings.

Research has shown that drug abuse treatment can help many individuals. Yet funding is often lacking for treatment because these programs compete for scarce resources with other important and effective social programs. This study shows how drug abuse treatment programs can be made more attractive to decision makers and funding agencies by first highlighting why economic evaluation is a critical component of drug abuse treatment research. Next, an evaluation methodology is presented that can be followed by program staff and researchers. The evaluation methodology includes aspects of cost-and-outcome analysis, cost-effectiveness analysis, and benefit-cost analysis. Methods and findings are then discussed from most of the major economic evaluation studies of drug and alcoholism treatment. Lastly, guidelines for conducting future economic evaluations are presented along with suggestions for how the results can be used for policy purposes and program planning.

Capital Financing↗
PubMed1993

The effects of time in drug abuse treatment and employment on posttreatment drug use and criminal activity.

The impact of length of stay in drug abuse treatment on follow-up drug use and criminal behavior has important clinical and policy implications. In this paper we use longitudinal data from the Treatment Outcome Prospective Study to estimate the simultaneous effects of time in treatment and employment outcomes--weeks worked and total earnings--on posttreatment drug use and criminal activity. The drug use/criminal activity variables include four indexes measuring the severity of use, drug-related problems, predatory illegal acts, and overall criminal behavior. The results show that time in treatment had a negative and statistically significant impact on these outcome variables for every modality with residential clients experiencing the largest relative impact. The time-in-treatment effect was robust even when employment outcomes were modeled jointly with drug use and criminal activity outcomes. These findings highlight the importance of length of stay in treatment in the recovery and rehabilitation of drug abusers.

Ambulatory Care↗
PubMed1992

New fluorescent derivatives of cyclosporin for use in immunoassays.

The synthesis of new fluorescent derivatives of cyclosporin is described and their affinity with the specific Sandoz monoclonal antibody investigated. Synthesis was carried out using cyclosporin-C-hemisuccinate as the starting material with monodansylcadaverine, 4-bromomethyl-7-methoxycoumarin, and 4-bromomethyl-6,7-dimethoxycoumarin as labels. After extraction the derivatives were purified by HPLC and their binding affinity with the monoclonal antibody evaluated by the Incstar Cyclo-Trac SP radioimmunoassay. All three derivatives showed good binding and it is suggested that they may be of use in an immunoassay for measuring cyclosporin.

Chromatography, High Pressure Liquid↗
PubMed1992

Training and employment programs in methadone treatment: client needs and desires.

Training and employment programs (TEP) in methadone treatment have declined in recent years. Yet heroin abusers who enter methadone treatment have historically high unemployment and low earnings compared to the general population and other treatment modalities. This paper reports on the first phase of a multiyear project to develop and evaluate TEPs for methadone treatment clients. Preliminary findings from the treatment intake survey of the pilot study are used to identify client needs and desires. Specifically, we report descriptive statistics for clients' (a) demographics, (b) education and training, (c) employment status, (d) income and expenditures, (e) interest in a TEP, and (f) labor market expectations thereafter. We conclude with a presentation of our proposed future analyses and a discussion of the policy implications of the project. Our main finding is that most addicts have a strong interest in training and employment services, but their expectations about the impact of such services is often unrealistic.

Adult↗
PubMed1992

A quality-of-life method for estimating the value of avoided morbidity.

We developed a quality-of-life method for valuing changes in health status. Our model determines changes in health attributes for different illnesses and then estimates the dollar value of the corresponding welfare losses. We used our quality-of-life approach to estimate willingness to pay to avoid asthma, a headache, a cough, bronchitis, and arthritis. Estimates derived using our method are similar to those obtained from more expensive and restrictive traditional methods.

Economics↗
PubMed1991

Flow injection immunoassay using a protein A immunoreactor.

Competitive immunoassays have been developed for the immunosuppressant cyclosporin A and the anti-asthmatic drug theophylline utilizing identical controlled pore glass-protein A microcolumns and flow injection techniques. For cyclosporin A the assay was based on a monoclonal antibody with fluorescence detection whilst for theophylline sheep antiserum and electrochemical detection was used.

Cyclosporine↗
PubMed1991

Benefit-cost analysis of hepatitis B vaccine programs for occupationally exposed workers.

The Occupational Safety and Health Administration proposed a vaccination program for workers exposed to the hepatitis B virus 12 or more times per year. We performed a benefit-cost analysis of the proposed regulation and an expanded rule that covers all at-risk workers, regardless of the number of exposures. The annualized cost of the proposed vaccination program is estimated at $60.4 million. We estimated the dollar benefit of the program using two methods. The first estimates the avoided cost of medical care, prophylaxis, and lost productivity at $124 million annually. The second approach includes the value of avoided pain and suffering from hepatitis B, thus increasing the total dollar benefit to $679 million. Although both methods indicate benefits are greater than program costs, the valuation of avoided pain and suffering substantially increases net benefits. Furthermore, providing the vaccine to all exposed workers is cost-effective if one or more cases of hepatitis B are avoided per 6500 workers annually.

Cost-Benefit Analysis↗
PubMed1991

Estimating the value of avoiding morbidity and mortality from foodborne illnesses.

When people consume products violating the Food, Drug, and Cosmetic (FD&C) Act they may experience morbidity or mortality from foodborne illness. Some studies have used survey data to estimate the dollar value of avoiding a few illnesses, but surveys are expensive and the resulting estimates cannot easily be generalized to the wide variety of foodborne illnesses. We develop a method that uses published data to estimate the value of avoiding morbidity and mortality from foodborne illnesses using two metrics--quality-adjusted life-years and dollars. The method first describes the effects of different illnesses on the patient and then converts these descriptions into changes in time spent in different health states with different relative utility weights. We use these estimated changes to compute losses in quality-adjusted life-years. We demonstrate our method and derive estimates for the value of avoiding a future case of botulism, salmonellosis, chronic hepatitis, and bladder cancer. Researchers can use our method to compare the value of avoiding all illnesses caused by violations of the FD&C Act. More importantly, government officials can use our method to quickly and cost-effectively generate morbidity and mortality valuation estimates for any illness for policy purposes.

Costs and Cost Analysis↗
PubMed1991

Conceptual framework for estimating the social cost of drug abuse.

Drug abuse imposes costs on individuals and society. Researchers have produced several studies on a subset of tangible costs of drug abuse and other illnesses, but key tangible costs sometimes have been overlooked and, even when recognized, rarely have been estimated. An assortment of intangible costs also have received very little research attention. This study outlines a comprehensive conceptual framework for estimating the social cost of drug abuse. We address both the tangible and intangible costs for the drug-abusing and non-drug-abusing population. Our conceptual framework is based on critical reviews of new and traditional methods for estimating the costs of illness and disease including cost-of-illness methods, averting behavior methods, and utility valuation techniques. We show how the proposed methods can be combined with existing data to estimate the total social cost of drug abuse. Using social cost estimates will enable policymakers to more accurately assess the total burden of drug abuse and related problems on society.

Costs and Cost Analysis↗
PubMed1991

The impact of time in treatment on the employment and earnings of drug abusers.

We use data from a longitudinal survey to estimate the effects of time in drug abuse treatment on post-treatment weeks worked and earnings for 2,420 clients in three treatment modalities. The regression analysis shows that time in treatment had a positive and statistically significant impact on these labor market outcomes, but the effects were small for all modalities. Although residential clients experienced the largest relative changes in weeks worked and real earnings, a benefit-cost calculation suggests that additional residential treatment cannot be justified from earnings improvements alone. These results may indicate a need for more employment services while in treatment.

Cost-Benefit Analysis↗