This PhD research will be jointly conducted with a current NHMRC-funded Access the Cost Effectiveness (ACE) Alcohol Indigenous project. Indigenous people have considerably shorter life expectancy than non-Indigenous Australians and alcohol is one of the contributing factors. Governments spend millions each year trying to close this health gap but there is little evidence to demonstrate this money is being spent appropriately. Assessing the economic efficiency of Indigenous alcohol policy requires examination of the effectiveness and cost-effectiveness of interventions; this will provide much-needed evidence about appropriate and effective policy.
This research will estimate the cost-effectiveness of a community-based program to reduce binge drinking among young indigenous Australians, as well as the cost-effectiveness and cost-benefit of providing treatment in an Indigenous-specific residential rehabilitation facility.
We will take a healthcare perspective to study a range of interventions currently targeted at Indigenous Australians. The ACE-Alcohol model will be used; this model was built on a broader body of priority-setting research that focused on cost-effectiveness analysis. Intervention cost-effectiveness will be evaluated over the lifetime of the Indigenous Australian population eligible for each intervention in a selected baseline year. All the costs for each intervention will be estimated using a combination of top-down and bottom-up methods. All costs of interventions will be adjusted to base year and discounted accordingly. For each intervention, an incremental cost-effectiveness ratio will be evaluated and compared to a threshold level. We will use current practice and partial null as comparators to aid in the comparative analysis and marginal analysis; this will identify how the interventions can be ordered in the most efficient package.
Ansari collected nearly all his required data in 2012. The cost-effectiveness of the youth-focused community prevention program will be completed in 2013, as will the cost-effectiveness and cost-benefit evaluations of residential rehabilitation.
Ansari has written substantial drafts of three papers for publication in the peer-review literature. He has presented his early findings to the communities with whom he is working.
The findings of the project will strengthen the evidence base required to develop appropriate and effective Indigenous health policy in Australia. It will also provide policymakers with evidence about a suitable mix of policies for a given set of budget constraints.