The Horizons Project: An empirical analysis of alcohol and drug treatment funding, purchasing and workforce mechanisms

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Date Commenced:
April 2017
Expected Date of Completion:
March 2020
Project Supporters:

NHMRC Project Grant (GNT1128100)

Drug Type:
Project Members: 
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Associate Professor
Ph +61 (2) 9385 0333
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Dr Jenny Chalmers
Conjoint Senior Lecturer
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Research Fellow
Ph +61 2 9385 6407
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Research Officer
Ph +61 2 9385 0449
Project Main Description: 

Alcohol and other drug (AOD) treatment is key for improving health and reducing the social impact of AOD use. However, the treatment itself is not the only variable that impacts on whether health outcomes are improved. The way in which treatment is funded, purchased, and staffed is likewise important. While these variables are important determinants of treatment outcomes, no Australian research to date has examined how the funding, purchasing, and staffing of treatment impacts on client treatment outcomes.

The key structural features associated with treatment outcomes are:

  1. Funding arrangements
  2. Purchasing mechanisms
  3. Provider type
  4. Workforce characteristics

This is the first Australian research to focus on these structural features and examine how the funding, purchasing, and staffing of treatment impacts on client treatment outcomes. This project, named Horizons, has been funded by the NHMRC (2017 to 2019).

The research team is committed to making this a capacity building project for the AOD sector. In addition to an Advisory Group, we are working closely with the range of key stakeholders in the sector: state/territory and federal funders, and the government and non-government treatment providers. Engagement with stakeholders will be sought across the research process through advice and consultation on research questions, data gathering, commentary and feedback on emerging findings, and the production of (user-friendly) materials summarising the results.

The project is supported by an Advisory Group, which includes the following members:

  • Mr Sam Biondo - CEO, Victorian Alcohol And other Drug Association (VAADA)
  • Ms Helene Delany - Manager, Alcohol and other Drug Policy, ACT Health
  • A/Prof Adrian Dunlop - Addiction Medicine Specialist, NSW Ministry of Health
  • Dr Moira Hewitt - Head, Tobacco Alcohol and Other Drugs Unit. Australian Institute of Health and Welfare
  • Ms Rebecca Lang - CEO, Queensland Network of Alcohol and Drug Agencies (QNADA)
  • Prof Ann Roche - Director, National Centre Education and Training on Addictions (NCETA)
  • Mr Ross Broad, A/Director, Drug Policy and Reform, Community Based Health Policy & Programs Branch, Department of Health and Human Services
  • Helen Taylor, A/Director, Alcohol and Other Drugs Strategy, Planning & Partnerships Unit, Mental Health Alcohol & Other Drugs Branch, Department of Health
  • Chris Killick-Moran, Director, Research and International Policy, Alcohol, Tobacco and Other Drugs Branch, Population Health and Sport Division, Department of Health

International advisors:

  • Dr Kerstin Stenius - Department of Mental Health & Substance Abuse Services, National Inst for Health & Welfare, Finland
  • A/Prof Jessica Storbjork - Stockholm University, Sweden
Project Collaborators: External: 

Dr Michael Livingston
La Trobe University

Dr Lynda Berends
Trace Research

Professor Harvey Whiteford
The University of Queensland

Rationale: 

The project will provide an empirical foundation to guide decisions about how to fund and purchase AOD treatment services. It has the potential to directly benefit AOD treatment providers, AOD treatment clients and policymakers in a number of ways. Having accurate information and empirical analyses on the funding arrangements, purchasing mechanisms and workforce characteristics of AOD agencies will help, amongst other things, to:

  • Better plan the ways in which treatment services are funded;
  • Understand the implications of different types of purchasing models;
  • Assist with the allocation of resources to maximise health and wellbeing outcomes; and
  • Gain insight into funding and workforce characteristics in relation to treatment outcomes to enhance the capacity of the AOD sector.   

The project outcomes will enhance the effectiveness and quality of AOD treatment services and help build the capacity of the AOD workforce. Importantly, the project will ultimately improve the treatment outcomes of people with alcohol and other drug problems, through knowledge of the kinds of funding and purchasing arrangements which lead to better treatment outcomes. More efficient health resource utilisation, resulting in more treatment places and/or higher quality care will help those seeking treatment for alcohol or other drug problems. 

Aims: 

This study aims to produce:

  • An evidence-based appraisal of the different funding, purchasing, and staffing models currently in practice throughout Australia, in relation to treatment outcomes.
  • Evidence-based recommendations about the funding, purchasing, and staffing models that produce the most positive treatment outcomes.
Design and Method: 

Research like this has not been possible because we lack comprehensive Australian AOD treatment service system data which links information about treatment episodes, agencies and funding. The data needed include:

  • Non-identifiable and not re-identifiable data on treatment episodes and people receiving treatment at each agency (through the AIHW AODTS-NMDS);
  • Funding data – the sources and amounts of funding to each AOD treatment agency (collected via the online Organisational Survey);
  • Purchasing data – the ways in which each agency is contracted to provide the AOD services (e.g. through competitive tendering, block grants and so on) (collected via the online Organisational Survey); and
  • The AOD workforce – the key characteristics of the AOD workforce in each agency (collected via the online Organisational Survey).

This is an ambitious project, with multiple data requirements. Some data are sensitive, and ethical processes (including the protection of privacy and confidentiality) will be maintained throughout the project. No individual or agency will be identifiable in any materials disseminated by project.

Progress/Update: 

We currently have ethics approval from The University of New South Wales (UNSW) Human Research Ethics Committee (HC17948), the AIHW Research Ethics Committee (EO2018/1/40), the HREC of the Northern Territory Department of Health and Menzies School of Health Research (HREC-2018-3074), Central Australian Human Research Ethics Committee (CA-18-3111), and SA Department for Health and Wellbeing HREC (HREC/18/SAH/58) to conduct the online organisational survey and, with the agency consent, to collect the non-identifiable and not re-identifiable corresponding treatment data from the AIHW’s AODTS NMDS. We have also submitted an ethics application to Department of Health WA HREC and are awaiting the outcome.

We are currently recruiting people who oversee AOD agencies (e.g. managers, CEOs, senior staff members, etc.) to participate in our organisational survey, and to ask their consent to access the non-identifiable and not re-identifiable AODTS NMDS records of their AOD treatment agency.

If you would like to receive regular project updates and/or are interested in participating in the research study please contact Dr Katinka van de Ven (email: k.vandeven@unsw.edu.au).

Project Research Area: 
Project Status: 
Current