Skip to main content

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)

Brennan, Alan; Hill-McManus, Daniel; Stone, Tony; Buykx, Penny; Ally, Abdallah; Pryce, Robert E.; Alston, Robert; Jones, Andrew; Cairns, Donal; Millar, Tim; Donmall, Michael; Phillips, Tom; Meier, Petra; Drummond, Colin

Authors

Alan Brennan

Daniel Hill-McManus

Tony Stone

Penny Buykx

Abdallah Ally

Robert E. Pryce

Robert Alston

Andrew Jones

Donal Cairns

Tim Millar

Michael Donmall

Petra Meier

Colin Drummond



Abstract

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.

Journal Article Type Article
Publication Date Jan 1, 2019
Journal Journal of studies on alcohol and drugs. Supplement
Electronic ISSN 1946-5858
Peer Reviewed Peer Reviewed
Issue s18
Pages 96-109
APA6 Citation Brennan, A., Hill-McManus, D., Stone, T., Buykx, P., Ally, A., Pryce, R. E., …Drummond, C. (2019). 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). Journal of Studies on Alocohol and Drugs -Supplement-, 96-109. https://doi.org/10.15288/jsads.2019.s18.96
DOI https://doi.org/10.15288/jsads.2019.s18.96
Publisher URL https://www.jsad.com/doi/full/10.15288/jsads.2019.s18.96

Files



You might also like



Downloadable Citations