Centre for Rural Criminology, School of Humanities, Arts, and Social Sciences, University of New England, Armidale, New South Wales, Australia; Drug Policy Modelling Program, Social Policy Research Centre, UNSW, Sydney, NSW, Australia.
Drug Policy Modelling Program, Social Policy Research Centre, UNSW, Sydney, NSW, Australia.
J Subst Abuse Treat. 2022 Jan;132:108467. doi: 10.1016/j.jsat.2021.108467. Epub 2021 May 8.
Both public (government-run), and not-for-profit (nongovernment) service providers provide alcohol and other drug (AOD) treatment services. Research has rarely studied the structural features of these providers, such as workforce characteristics, procurement arrangements, and funding security. The study reported here sought to document and analyze the differences between these two AOD treatment provider types in Australia.
The study administered an online survey instrument targeted at managers of AOD treatment sites. The survey comprised three sections: (1) the service (e.g., treatment types); (2) workforce (e.g., total number of staff); and (3) funding and procurement arrangements (e.g., contract length). The study completed a total of 207 site surveys. The studied compared government and nongovernment services on structural features that may create a more or less sustainable or vulnerable service (funding arrangements, payment mechanisms, and contract length).
Government providers were more likely to provide medically oriented treatment types such as withdrawal management and pharmacotherapy, whereas nongovernment organization (NGO) providers were more likely to offer rehabilitation. Consistent with this, government services were more likely to employ medical professionals and nurses, indicative of a more medically oriented workforce, while NGO services were more likely to employ AOD workers, youth workers, peer workers, and counselors. Our data illustrate that NGO services were more likely to be subject to competitive tendering and to have shorter contract lengths, compared with government services, and overall to be more structurally vulnerable.
Despite the reliance on NGOs to provide the majority of specialist care (71% of all treatment episodes in Australia), these services are more vulnerable than their government counterparts. To ensure that a comprehensive suite of treatment services is available, procurement arrangements that support stability and security in nongovernment service providers and government service providers are essential.
公立（政府经营）和非营利（非政府）服务提供者均提供酒精和其他药物（AOD）治疗服务。研究很少研究这些提供者的结构特征，例如劳动力特征、采购安排和资金保障。本报告中所研究的旨在记录和分析澳大利亚这两种 AOD 治疗提供者类型之间的差异。
该研究向 AOD 治疗场所的管理人员发放了在线调查工具。该调查包括三个部分：（1）服务（例如，治疗类型）；（2）劳动力（例如，员工总数）；（3）资金和采购安排（例如，合同期限）。该研究共完成了 207 个场所调查。该研究比较了政府和非政府服务在可能创造更可持续或更脆弱服务的结构特征方面的差异（资金安排、付款机制和合同期限）。
政府提供者更有可能提供以医疗为导向的治疗类型，例如戒断管理和药物治疗，而非政府组织（NGO）提供者更有可能提供康复服务。与之相符的是，政府服务更有可能雇用医疗专业人员和护士，表明劳动力更具医疗导向性，而非政府组织服务更有可能雇用酒精和其他药物工作者、青年工作者、同伴工作者和顾问。我们的数据表明，与政府服务相比，非政府组织服务更有可能受到竞争性招标的影响，并且合同期限更短，总体而言结构更为脆弱。
尽管非政府组织依赖于提供大部分专业护理（澳大利亚所有治疗病例的 71%），但这些服务比政府对应服务更脆弱。为确保提供全面的治疗服务，必须为非政府组织服务提供者和政府服务提供者提供支持稳定性和保障性的采购安排。
