Exploring resource implications and models of care for assessment and diagnosis of fetal alcohol spectrum disorder: A scoping review

Nykola Kent, Nicole Hayes, Sophia Young, Chelsea Vanderpeet, Dianne Shanley, Katrina Harris, Carmela Pestell, Elizabeth Elliott, Natasha Reid

Research output: Contribution to journalReview articlepeer-review

1 Citation (Web of Science)


Previous reviews have examined annual mean costs of care for individuals with fetal alcohol spectrum disorder (FASD), costs of the health burden, costs to the justice system, productivity losses for caregivers, and both the monetary and nonmonetary costs of reduced quality of life. However, because there have been no published reviews focused on understanding the resource implications and specific service features for the assessment and diagnostic process for FASD, the current scoping review investigated the available evidence on these topics. Eligible studies were identified through a systematic search of six databases and included if they contained information on the potential costs or models of care associated with undertaking an assessment for FASD. Data were charted, underwent content analysis, and were reported according to the PRISMA extension for scoping reviews. Eleven studies were included in the final qualitative synthesis. The primary patient costs were attributed to the lengthy time required for diagnosis (up to 47 h). The primary service costs were attributed to costs of clinicians and support personnel and the involvement of multidisciplinary teams in the assessment process. Estimates of the specific dollar values of diagnostic costs were limited and varied between studies. Several models of care were explored, primarily in Canadian clinics, which aimed to capitalize on available services to improve accessibility and patient care and reduce service costs. This study provides important preliminary insights into the resource implications and models of care involved in the diagnostic assessment of FASD. However, the low number of available studies and variability in available data highlight the need for formal costing studies and detailed information gathering on available models of care to inform future clinical practice and policy development.
Original languageEnglish
Pages (from-to)2022-2032
Number of pages11
JournalAlcohol: Clinical and Experimental Research
Issue number11
Early online date26 Sept 2023
Publication statusPublished - Nov 2023


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