TY - JOUR

T1 - Modeling the Potential Impact of Changing Access Rates to Specialist Treatment for Alcohol Dependence for Local Authorities in England: The Specialist Treatment for Alcohol Model (STreAM)

AU - Brennan, Alan

AU - Hill-McManus, Daniel

AU - Stone, Tony

AU - Buykx, Penny

AU - Ally, Abdallah

AU - Pryce, Robert E.

AU - Alston, Robert

AU - Jones, Andrew

AU - Cairns, Donal

AU - Millar, Tim

AU - Donmall, Michael

AU - Phillips, Tom

AU - Meier, Petra

AU - Drummond, Colin

PY - 2019/1/28

Y1 - 2019/1/28

N2 - OBJECTIVE: We modeled the impact of changing Specialist Treatment Access Rates to different treatment pathways on the future prevalence of alcohol dependence, treatment outcomes, service capacity, costs, and mortality.METHOD: Local Authority numbers and the prevalence of people "potentially in need of assessment for and treatment in specialist services for alcohol dependence" (PINASTFAD) are estimated by mild, moderate, severe, and complex needs. Administrative data were used to estimate the Specialist Treatment Access Rate per PINASTFAD person and classify 22 different treatment pathways. Other model inputs include natural remission, relapse after treatment, service costs, and mortality rates. "What-if" analyses assess changes to Specialist Treatment Access Rates and treatment pathways. Model outputs include the numbers and prevalence of people who are PINASTFAD, numbers treated by 22 pathways, outcomes (successful completion with abstinence, successfully moderated nonproblematic drinking, re-treatment within 6 months, dropout, transfer, custody), mortality rates, capacity requirements (numbers in contact with community services or staying in residential or inpatient places), total treatment costs, and general health care savings. Five scenarios illustrate functionality: (a) no change, (b) achieve access rates at the 70th percentile nationally, (c) increase access by 25%, (d) increase access to Scotland rate, and (e) reduce access by 25%.RESULTS: At baseline, 14,581 people are PINASTFAD (2.43% of adults) and the Specialist Treatment Access Rate is 10.84%. The 5-year impact of scenarios on PINASTFAD numbers (vs. no change) are (B) reduced by 191 (-1.3%), (C) reduced by 477 (-3.3%), (D) reduced by almost 2,800 (-19.2%), and (E) increased by 533 (+3.6%). The relative impact is similar for other outputs.CONCLUSIONS: Decision makers can estimate the potential impact of changing Specialist Treatment Access Rates for alcohol dependence.

AB - OBJECTIVE: We modeled the impact of changing Specialist Treatment Access Rates to different treatment pathways on the future prevalence of alcohol dependence, treatment outcomes, service capacity, costs, and mortality.METHOD: Local Authority numbers and the prevalence of people "potentially in need of assessment for and treatment in specialist services for alcohol dependence" (PINASTFAD) are estimated by mild, moderate, severe, and complex needs. Administrative data were used to estimate the Specialist Treatment Access Rate per PINASTFAD person and classify 22 different treatment pathways. Other model inputs include natural remission, relapse after treatment, service costs, and mortality rates. "What-if" analyses assess changes to Specialist Treatment Access Rates and treatment pathways. Model outputs include the numbers and prevalence of people who are PINASTFAD, numbers treated by 22 pathways, outcomes (successful completion with abstinence, successfully moderated nonproblematic drinking, re-treatment within 6 months, dropout, transfer, custody), mortality rates, capacity requirements (numbers in contact with community services or staying in residential or inpatient places), total treatment costs, and general health care savings. Five scenarios illustrate functionality: (a) no change, (b) achieve access rates at the 70th percentile nationally, (c) increase access by 25%, (d) increase access to Scotland rate, and (e) reduce access by 25%.RESULTS: At baseline, 14,581 people are PINASTFAD (2.43% of adults) and the Specialist Treatment Access Rate is 10.84%. The 5-year impact of scenarios on PINASTFAD numbers (vs. no change) are (B) reduced by 191 (-1.3%), (C) reduced by 477 (-3.3%), (D) reduced by almost 2,800 (-19.2%), and (E) increased by 533 (+3.6%). The relative impact is similar for other outputs.CONCLUSIONS: Decision makers can estimate the potential impact of changing Specialist Treatment Access Rates for alcohol dependence.

U2 - 10.15288/jsads.2019.s18.96

DO - 10.15288/jsads.2019.s18.96

M3 - Article

C2 - 30681953

VL - Sup 18

SP - 96

EP - 109

JO - Journal of Studies on Alcohol and Drugs

JF - Journal of Studies on Alcohol and Drugs

IS - s18

ER -