Hyshka Elaine, Karekezi Kamagaju, Tan Benjamin, Slater Linda G, Jahrig Jesse, Wild T Cameron
School of Public Health, 3-300 Edmonton Clinic Health Academy, University of Alberta, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
Inner City Health and Wellness Program, B818 Women's Centre, Royal Alexandra Hospital, 10240 Kingsway Avenue, Edmonton, AB, T5H 3VR, Canada.
BMC Health Serv Res. 2017 Mar 20;17(1):217. doi: 10.1186/s12913-017-2153-z.
A growing body of research assesses population need for substance use services. However, the extent to which survey research incorporates expert versus consumer perspectives on service need is unknown. We conducted a large, international review to (1) describe extant research on population need for substance use services, and the extent to which it incorporates expert and consumer perspectives on service need, (2) critically assess methodological and measurement approaches used to study consumer-defined need, and (3) examine the potential for existing research that prioritizes consumer perspectives to inform substance use service system planning.
Systematic searches of seven databases identified 1930 peer-reviewed articles addressing population need for substance use services between January 1980 and May 2015. Empirical studies (n = 1887) were categorized according to source(s) of data used to derive population estimates of service need (administrative records, biological samples, qualitative data, and/or quantitative surveys). Quantitative survey studies (n = 1594) were categorized as to whether service need was assessed from an expert and/or consumer perspective; studies employing consumer-defined need measures (n = 217) received further in-depth quantitative coding to describe study designs and measurement strategies.
Almost all survey studies (96%; n = 1534) used diagnostically-oriented measures derived from an expert perspective to assess service need. Of the small number (14%, n = 217) of survey studies that assessed consumer's perspectives, most (77%) measured perceived need for generic services (i.e. 'treatment'), with fewer (42%) examining self-assessed barriers to service use, or informal help-seeking from family and friends (10%). Unstandardized measures were commonly used, and very little research was longitudinal or tested hypotheses. Only one study used a consumer-defined need measure to estimate required service system capacity.
Rhetorical calls for including consumer perspectives in substance use service system planning are belied by the empirical literature, which is dominated by expert-driven approaches to measuring population need. Studies addressing consumer-defined need for substance use services are conceptually underdeveloped, and exhibit methodological and measurement weaknesses. Further scholarship is needed to integrate multidisciplinary perspectives in this literature, and fully realize the promise of incorporating consumer perspectives into substance use service system planning.
越来越多的研究开始评估人群对物质使用服务的需求。然而，调查研究在纳入专家与消费者对服务需求的看法方面的程度尚不清楚。我们进行了一项大型的国际综述，以（1）描述关于人群对物质使用服务需求的现有研究，以及该研究纳入专家和消费者对服务需求看法的程度，（2）批判性地评估用于研究消费者定义需求的方法和测量方法，以及（3）研究优先考虑消费者观点的现有研究为物质使用服务系统规划提供信息的潜力。
对七个数据库进行系统检索，确定了1930篇在1980年1月至2015年5月期间涉及人群对物质使用服务需求的同行评议文章。实证研究（n = 1887）根据用于得出服务需求人群估计值的数据来源（行政记录、生物样本、定性数据和/或定量调查）进行分类。定量调查研究（n = 1594）根据是否从专家和/或消费者角度评估服务需求进行分类；采用消费者定义需求测量方法的研究（n = 217）接受了进一步深入的定量编码，以描述研究设计和测量策略。
几乎所有的调查研究（96%；n = 1534）都使用从专家角度得出的以诊断为导向的测量方法来评估服务需求。在评估消费者观点的少数调查研究（14%，n = 217）中，大多数（77%）测量了对一般服务（即“治疗”）的感知需求，较少（42%）研究自我评估的服务使用障碍，或向家人和朋友寻求非正式帮助的情况（10%）。非标准化测量方法普遍使用，纵向研究或检验假设的研究很少。只有一项研究使用消费者定义的需求测量方法来估计所需的服务系统容量。
实证文献与在物质使用服务系统规划中纳入消费者观点的理论呼吁相悖，该文献主要由专家驱动的测量人群需求的方法主导。针对消费者定义的物质使用服务需求的研究在概念上不够完善，并且存在方法和测量方面的弱点。需要进一步的学术研究来整合该文献中的多学科观点，并充分实现将消费者观点纳入物质使用服务系统规划的前景。
