Download - Cost Program: Barbados Experience
![Page 1: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/1.jpg)
Cost Program: Barbados Experience
Jonathan M. YearwoodJonathan M. YearwoodResearch and Information OfficerResearch and Information Officer
National Council on Substance AbuseNational Council on Substance Abuse(NCSA)(NCSA)
![Page 2: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/2.jpg)
Barbados’ Contribution to the Cost Study
Estimating The Human, Social, and Economic Costs of Drugs in the
Americas
![Page 3: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/3.jpg)
Barbados’ Contribution to the Cost Study
The NCSA (Barbados) conducted three (3) separate studies. These reports were:
Estimating Direct Government Expenditure on Drug Demand Reduction in Barbados (November 2003)
Survey of Emergency Rooms in Barbados (September 2004)
The Estimation of Costs Attributable to Substance Abuse and Loss of Productivity for Inmates at Glendairy Prison: Barbados (November 2004).
![Page 4: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/4.jpg)
Estimating Direct Government Expenditure
on Drug Demand Reduction in Barbados
(EDGE)
![Page 5: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/5.jpg)
Objectives of the EDGE Study
The main objectives of the study were:To estimate Government Expenditure on
demand reduction activities; To collect and report data required for the
indicators known as level one indicators; To provide a basis on which to build future
studies as the pilot project progresses.
![Page 6: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/6.jpg)
Methodology
The methodology employed was:The use of secondary data on drug related
costs and activities for some institutions in the health and criminal justice sectors.
The secondary data provided the basis for estimating government expenditure.
![Page 7: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/7.jpg)
Table 1 Estimates of Total Government
Expenditure on Demand Reduction
Year
Institution 1996 1997 1998 1999 2000
NCSA $624,457 $678,323 $706,077 $989,036$1,256,04
9
Drug Rehab Unit $4,578,50
9$4,954,810
$4,436,461
$2,221,621
$2,093,553
Total $5,202,966
$5,633,133
$5,142,538
$3,210,657
$3,349,602
![Page 8: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/8.jpg)
Figure 1Estimate of Total Government
Expenditure on Demand Reduction
1996 1997 1998 1999 2000
$0.00
$1,000,000.00
$2,000,000.00
$3,000,000.00
$4,000,000.00
$5,000,000.00
$6,000,000.00
Estimate of Total Government Expenditure on Demand Reduction
![Page 9: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/9.jpg)
Analysis of EDGE Study
Administrators need to keep track of spending.
No data is provided for yearly requests and therefore an estimate cannot be provided.
![Page 10: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/10.jpg)
Analysis of EDGE Study
A standardised data collection instrument for all health-care providers.
Central depository for studies of this type will be needed.
![Page 11: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/11.jpg)
Survey of
Emergency Rooms in Barbados
(The ER Study)
![Page 12: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/12.jpg)
Objectives of ER Study
To determine the prevalence of drug use in the patients
To establish the relative importance and the characteristics of drug use
To quantify the association between drug use and accidents.
To test a methodology that may be easily applied in different countries.
Collect data on Level 1 direct cost indicators..
![Page 13: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/13.jpg)
Methodology
The study was conducted at the two institutions (QEH and FMH).
A CICAD standardized questionnaire was used.
Interviews were conducted on a 24-hour & 18 hour respectively.
The study was conducted among persons - 12 years and older.
Data was collected a two-week period.
![Page 14: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/14.jpg)
Survey Information
Patient Data collected:– the date and time of the emergency;– basic demographics of the patients;– type of emergency;– substance use in the six hours prior to the interview;
and– the possible relationship between consumption and the
emergency. Doctor’s clinical impression was notedNo laboratory tests were conducted
![Page 15: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/15.jpg)
Estimation of ER Cost Data - QEH
The 1996 by Boston University Report guided the survey.
The cost data for the survey was based on assumed patterns of expenditure for 1995 – 2003.
![Page 16: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/16.jpg)
Pattern of Expenditure for QEH
In 1995: Expenditure on the QEH = $83.9m.
– $5.2m (6.2%) – A & E services.
In 2002 – 2003Expenditure on the QEH = $115.3m.
– $7.15m (6.2%) A & E services
![Page 17: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/17.jpg)
Pattern of Expenditure for QEH Cont’d
The ER study shows – 3.6% had an emergency related to drug
use;– 3.6% of the expenditure was consistent for
two years;Estimated cost for 2002 – 2003 =3.6%
of 7.15m ($260,000) could have been spent on drug related accidents at the QEH.
![Page 18: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/18.jpg)
Analysis of ER Study
Survey was conducted over a normal two (2) week period.
Estimate of 0.8% of admissions are drug related.
A rough estimate of admittances from drug consumption should be given.
![Page 19: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/19.jpg)
The Estimation of Costs Attributable to Substance Abuse
and Loss of Productivity for Inmates at
Glendairy Prison in Barbados (The Prison Study)
![Page 20: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/20.jpg)
Objectives of the Prison Study
Objectives of the prison study were to determine: – The relationship between drug use and criminal
behaviour;– The frequency of drug use;– Persons imprisoned for crimes or offences
associated with substance use;– Type of offences committed;– The economic loss due to drug related crime
![Page 21: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/21.jpg)
Methodology
A random stratified sample among non-remand inmates;
150 inmates were chosen;
The actual sample size was 140 inmates (93%)
![Page 22: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/22.jpg)
Stratified Sample
Type of
crimes
Other RTO Damage Robbery Theft Burglary Fire-arms
Sexualcrimes
Drugcrime
Violentcrimes
Total
Non-remand
52 12 12 59 133 68 68 57 200 166 817
Percent 6% 1% 1% 7% 16% 8% 8% 7% 24% 20% 100
Sample 9 2 2 11 24 12 12 10 37 30 150
![Page 23: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/23.jpg)
Major Categories of the Survey
Under the influence of illicit drugs and alcohol.
Acquisition of drugs.
Involvement in the drug economy.
Drug trafficking and production:
![Page 24: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/24.jpg)
Economic Loss Due to Drug-related Crimes
The formula
Cost of incarceration
Loss of productivity cost
Economic cost of a prisoner
(Perez et al 2004)
+
![Page 25: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/25.jpg)
Cost of Incarceration Results
The average cost – Daily = BDS $33.65.– Over eight years (1996 -2004) = $72,962.83.
To maintain the 19 inmates for the duration of their sentences
BDS $1,386,293.69.
![Page 26: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/26.jpg)
Loss of Productivity Results
The average loss of productivity – BDS $14,378.42
The total loss of productivity – BDS $273,190.00
Almost four times less than the cost of housing the prisoners.
![Page 27: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/27.jpg)
Total Economic Loss
19 (10%) inmates over the eight year period – BDS$87,341.25
The total economic loss to Barbados – $1,659,483.69,
Estimated cost to the Barbadian government – $16,600,000.00
![Page 28: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/28.jpg)
INMATEID
MOUTHSIN PRISON
NO. OFCONVICTIONS
LENGTH OFSENTENCE
(MTHS)
TOTAL COSTPER DAY
DAILYCOST
WAGESPER MTH
COST INPRISON
ECONOMICLOSS
1 9 1 18 $8,662.23 $33.97 $6,192.86 $17,120.64 $23,313.50
2 39 1 60 $36,150.75 $33.26 $26,398.57 $55,872.36 $82,270.93
3 9 1 18 $8,356.50 $33.97 $5,974.29 $17,120.64 $23,094.92
4 49 1 180 $45,241.36 $32.97 $33,320.00 $166,192.75 $199,512.75
5 13 1 36 $12,578.01 $33.81 $9,034.29 $34,082.36 $43,116.64
6 16 1 36 $15,253.31 $33.75 $10,977.14 $34,016.22 $44,993.36
7 28 1 60 $25,807.10 $33.52 $18,700.00 $56,306.39 $75,006.39
8 7 1 30 $6,488.18 $33.97 $4,638.57 $28,534.40 $33,172.97
9 7 1 24 $7,031.69 $33.97 $5,027.14 $22,827.52 $27,854.66
10 49 1 180 $45,241.36 $32.97 $33,320.00 $166,192.75 $199,512.75
11 5 1 60 $4,517.95 $33.97 $3,230.00 $57,068.80 $60,298.80
12 8 1 132 $7,439.33 $33.97 $5,318.57 $125,551.35 $130,869.92
13 8 1 60 $7,677.11 $33.97 $5,488.57 $57,068.80 $62,557.37
14 48 1 60 $44,547.55 $33.02 $32,761.43 $55,478.05 $88,239.48
15 49 1 300 $45,241.36 $32.97 $33,320.00 $276,987.92 $310,307.92
16 16 1 48 $14,651.36 $33.76 $10,540.00 $45,371.97 $55,911.97
17 7 1 60 $6,997.72 $33.97 $5,002.86 $57,068.80 $62,071.65
18 26 1 60 $24,524.69 $33.55 $17,752.86 $56,363.18 $74,116.03
19 9 1 60 $8,662.23 $33.97 $6,192.86 $57,068.80 $63,261.65
TOTAL $375,069.78 $639.31 $273,190.00 $1,386,293.69 $1,659,483.69
MEAN $19,740.51 $33.65 $14,378.42 $72,962.83 $87,341.25
![Page 29: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/29.jpg)
Analysis Prison Study
The formula is unclear as outlined below:
– Number of Convictions vs. Total sentences:
– Length of Sentence:
![Page 30: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/30.jpg)
Analysis Prison Study Cont’d
A systematic database of prison records which includes
– reason for incarceration, – length of sentence, – profession and – average income.
![Page 31: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/31.jpg)
Analysis Prison Study Cont’d
Estimating loss of productivity:
Due to the non-normal distribution of income in Barbados, the loss of productivity would be underestimated.
If median income in the island is utilised, a more accurate figure may result.
![Page 32: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/32.jpg)
Conclusion
The Cost Studies provided baseline data from which government expenditures on demand reduction activities and prison costs could be estimated.
These costs estimations may vary from existing government procedures for estimating costs.
![Page 33: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/33.jpg)
Conclusion
The gap between government estimates and those of the cost studies may vary due to the presence of other tangible and intangible costs absent from the cost study estimates.
![Page 34: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/34.jpg)
What is therefore needed is a bridging of
government and cost study estimates which
will allow for more robust costs estimations.
![Page 35: Cost Program: Barbados Experience](https://reader035.vdocuments.mx/reader035/viewer/2022062723/56813c2a550346895da5a64e/html5/thumbnails/35.jpg)
Discussion