Key Considerations in Planning for Substance Use Treatment: Estimating Treatment Need and Demand

Abstract

Objective: Estimates of the extent of treatment need (defined by the presence of a diagnosis for which there is an effective treatment available) and treatment demand (defined as treatment seeking) are essential parts of effective treatment planning, service provision, and treatment funding. This article reviews the existing literature on approaches to estimating need and demand and the use of models to inform such estimation, and then considers the implications for health planners. Method: A thematic review of the literature was undertaken, with a focus on covering the key concepts and research methods that have been used to date. Results: Both need and demand are important estimates in planning for services but contain many difficulties in moving from the theory of measurement to the practicalities of establishing these figures. Furthermore, the simple quantum of need or demand is limited in its usefulness unless it is matched with consideration of different treatment types and their relative intensity, and/or explored as a function of geography and subpopulation. Modeling can assist with establishing more fine-tuned planning estimates, and is able to take into account both client severity and the various treatment types that might be available. Conclusions: Moving from relatively simplistic estimates of need and demand for treatment, this review has shown that although such estimation can inform national or subnational treatment planning, more sophisticated models are required for alcohol and other drug treatment planning. These can help health planners to determine the appropriate amount and mix of treatments for substance use disorders. Objectif : L’estimation de l’ampleur du besoin de traitement, défini par la présence d’un diagnostic pour lequel un traitement efficace est disponible, et la demande de traitement, définie par la recherche de traitement, sont des éléments essentiels à une planification efficace du traitement, à la prestation de service et à son financement. Cet article passe en revue la littérature existante sur les approches pour estimer le besoin et la demande ainsi que l’utilisation de modèles pour documenter une telle estimation, puis considère les implications pour les planificateurs des services de santé. Méthode : Une revue thématique de la littérature a été entreprise en mettant l’accent sur les concepts clés et les méthodes de recherche qui ont été utilisées à ce jour. Résultats : Les estimations des besoins et de la demande sont toutes deux importantes dans la planification des services, mais constituent des défis importants lors du passage de la théorie de la mesure aux aspects plus pratiques de production de ces estimations. Par ailleurs, la simple estimation d’un nombre lié au besoin ou à la demande est limitée, à moins qu’elle ne soit appariée avec différents types de traitement et leur intens...

Strengths, challenges, and future directions for the non-government alcohol and other drugs workforce

“…Specifically, workforce planning strategies are needed to ameliorate the impact of potential staff losses and to support those workers with little formal experience or specialized training. As highlighted by Ritter et al (2019), a comprehensive understanding of the AOD treatment service system, including the workforce, is essential for advanced planning efforts.…”

“…Recruitment, retention, and continuous improvement of skilled workers is imperative. Effective health workforce planning and workforce development is required to ensure that appropriate numbers of competent workers are available to meet current and future demand (Ritter et al, 2019). Such concerns are particularly salient in the Australian healthcare context, characterized by multiple complexities, reform efforts, aging practitioner and patient populations, unequal workforce distributions, and healthcare supply/mismatches (Gorman, 2015).…”

Needs-Based Planning for Substance Use Treatment Systems: Progress, Prospects, and the Search for a New Perspective

“…If nothing else, the articles in this Supplement show that progress has been made in a variety of areas. This includes defining core concepts and principles (Ritter et al, 2019b; Rush & Urbanoski, 2019); developing models and measures that capture the complexity of treatment need (Hirschovits-Gerz et al, 2019; Mota et al, 2019; Rush et al, 2019; Tremblay et al, 2019); and applying those innovations within more dynamic system modeling that incorporates incidence,naturalrecovery, and outcomes, for example (Brennan et al, 2019).…”

The Need for Needs-Based Planning: A Commentary

“…The models presented in these three articles offer a template for future treatment system modeling efforts at the local government level. Rather than starting from scratch, all three articles build on earlier local modeling efforts, either by Rush (1990) or by Ritter and colleagues (2013). Building on these earlier efforts is essential to promote consistency across models.…”