Costing alcohol-related assault in the night-time economy from a societal perspective: The case of Central Sydney

Drug Alcohol Rev. 2021 Jul;40(5):779-799. doi: 10.1111/dar.13242. Epub 2021 Feb 25.

Abstract

Introduction: There is a concern in many countries about violence from late-night alcohol sales and appropriate regulatory responses. However, economic losses arising from this activity rarely feature in public debate. Credible estimates are lacking because economic evaluations have not taken a 'societal perspective', costing health, policing and criminal justice outcomes. Our aims were to: (i) develop an analytic model capable of informing cost-benefit analysis of policy changes; and (ii) estimate costs of alcohol-related assault (ARA) in a major city.

Methods: We employed decision-analytic cohort models of health and judicial consequences of ARA in Sydney, Australia. We constructed two 6-branch decision-analytic models of patient and offender pathways through the health and judicial systems. We produced overall estimates and analysed their sensitivity to key assumptions.

Results: Combining results from a Health model comprising 40 pathways and 137 cost events, and a Justice model comprising 20 pathways and 48 cost events, yielded an overall cost estimate of $85 093 per ARA, of which 64% was health-related, while 36% was justice-related. Estimates were sensitive to values assigned for 'pain, suffering, morbidity and wellbeing', and to costs of incarceration. Health service-related costs accounted for 1.3% of the total.

Discussion and conclusion: The costs of ARA are significant and dominated by incidents in which a victim does not necessarily receive acute medical care but suffers loss in quality-of-life, and where a perpetrator is processed through the criminal justice system. Being derived transparently, within a theoretical framework, the estimates are adaptable to inform cost-benefit analyses of policy options in Australia and other countries.

Keywords: alcohol; assault; cost; economy; night-time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Crime Victims*
  • Criminal Law
  • Health Care Costs
  • Health Services
  • Humans