Die Methode bestimmt das Ergebnis: Indirekte ökonomische Folgen von Alkoholmissbrauch und -abhängigkeit in der Schweiz[1]

Zusammenfassung

Anliegen: Die vorliegende Arbeit hat zum Ziel aufzuzeigen, welche methodischen Probleme bei der Schätzung indirekter sozialer Kosten durch Alkoholkonsum auftreten können. Methode: Zur Schätzung alkoholbedingter Produktivitätsverluste durch Exzessmorbidität wurden Regressionsanalysen gerechnet mit Daten der 2. Schweizer Gesundheitsbefragung (1997). Im Sinne einer Sensitivitätsanalyse sind zwei verschiedene Ansätze (Ricescher und Harwoodscher Ansatz), mit und ohne Smearing-Adjustierung bzw. mit und ohne Adjustierung für Kontrollvariablen gerechnet worden. Ergebnisse: Die vorliegende Untersuchung zeigt, dass geringfügige Änderungen in der Methodik zu enormen Schwankungen in den geschätzten Gesamtkosten führen können. In monetären Werten belaufen sich die indirekten sozialen Kosten des Alkoholkonsums in der Schweiz durch Exzessmorbidität auf jährlich zwischen 0,119 Mrd. CHF (Modell Harwood, smearing-adjustiert) und 2,175 Mrd. CHF (Modell Rice, adjustiert für Kontrollvariablen). Schlussfolgerungen: Angesichts zahlreicher methodisch noch ungeklärter Fragen bei der Schätzung von indirekten sozialen Kosten des Alkoholkonsums muss die Aussagekraft von Kostenstudien stark relativiert werden.

Economical Effects of Abuse in Alcohol and Alcoholism in Switzerland

Objective: The present contribution aims at illustrating the methodological problems that may arise from investigating the indirect social costs of alcohol consumption. Methods: In order to estimate the alcohol-related productivity losses through excessive morbidity, regression analysis was performed, using data from the 2^nd Swiss Health Survey (1997). For the purpose of sensitivity analysis two approaches were used (a) Rice and b) Harwood), and all models were calculated with and without smearing-adjustment as well as with and without adjustment for confounding variables. Results: The present study shows that small changes in method may result in major variations in the estimated total costs. In monetary terms, the indirect costs for alcohol consumption in Switzerland through excess-morbidity were estimated at between 0.119 billion Francs (model Harwood, smearing-adjusted) and 2.175 billions Francs (model Rice, adjusted for confounding variables). Conclusion: Since many methodological problems in estimating the indirect costs of alcohol consumption have not been adequately resolved yet, results of those studies have to be interpreted with caution.

1 Die vorliegende Arbeit wurde vom Schweizer Bundesamt für Gesundheit (BAG Nr. 98.000794/8120) gefördert. Sie spiegelt die Meinung der beiden Autoren wider und nicht notwendigerweise diejenige des BAG.

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1 Die vorliegende Arbeit wurde vom Schweizer Bundesamt für Gesundheit (BAG Nr. 98.000794/8120) gefördert. Sie spiegelt die Meinung der beiden Autoren wider und nicht notwendigerweise diejenige des BAG.

2 Note that control variables are those of the Harwood et al. [1] estimation. Ours are presented in the chapter on alcohol-related productivity losses in Switzerland.