School of Population Health, UNSW Sydney, Sydney, Australia.
Network of Alcohol and other Drugs Agencies, Sydney, Australia.
Addiction. 2023 Jan;118(1):119-127. doi: 10.1111/add.16038. Epub 2022 Sep 11.
While many studies have examined outcome measurement as part of clinical trials and routine outcome collection at the person-level in alcohol and other drug (AOD) treatment services, there has been limited attention to measures required to assess performance at the service-level. In Australia, non-government services are primarily funded by government using public funds; however, there is no standardized approach to performance measurement. This study sought to establish a finite list of performance measures that represented consensus between funders, treatment providers and service-users.
A three-round Delphi process was undertaken with (i) funders of treatment (n = 10), (ii) treatment providers (n = 10) and (iii) treatment service-users (n = 10). Participants were asked to rate a range of measures on a 10-point Likert scale on how important they were to be included in contracts with funders. Measures with a median score > 7 and agreement among participants above 70% were the criteria for inclusion in the final set of measures. Qualitative data in the form of text responses provided by participants for their ratings in rounds 1 and 2 were also analysed.
Participants rated 93 measures in round 1, which reduced to 78 measures in round 2 and 32 measures in round 3. Fifteen service-level measures and two system-level measures met criteria for inclusion in the final set of performance measures. The final set of measures cover a range of measurement types: outcomes (n = 5), access (n = 3), structural (n = 3), experience (n = 2), input (n = 2), process (n = 1) and output (n = 1).
In Australia, performance measures for alcohol and other drug treatment services that represent a consensus among service-users, providers and funders focus upon demonstrating accountability for public funds, improving services and communicating key measures of success to future service-users and the broader community.
尽管许多研究已经在临床试验中检查了结果测量，并且在酒精和其他药物（AOD）治疗服务中以个人为单位进行了常规结果收集，但对于评估服务水平所需的措施关注有限。在澳大利亚，非政府服务主要由政府使用公共资金资助；然而，对于绩效衡量没有标准化的方法。本研究旨在确定一套有限的绩效衡量标准，这些标准代表了资助者、治疗提供者和服务使用者之间的共识。
采用三轮 Delphi 流程，参与者包括：（i）治疗的资助者（n=10）、（ii）治疗提供者（n=10）和（iii）治疗服务使用者（n=10）。参与者被要求在 10 分制的 Likert 量表上对一系列措施进行评分，以确定他们认为这些措施对与资助者签订合同的重要性。评分中位数>7 且参与者的一致性超过 70%的措施为纳入最终措施集的标准。还对参与者在第 1 轮和第 2 轮的评分提供的文本回复进行了定性数据分析。
参与者在第 1 轮中对 93 项措施进行了评分，在第 2 轮和第 3 轮中减少到 78 项和 32 项措施。15 项服务水平措施和 2 项系统水平措施符合纳入最终绩效措施集的标准。最终措施集涵盖了一系列测量类型：结果（n=5）、准入（n=3）、结构（n=3）、体验（n=2）、投入（n=2）、过程（n=1）和产出（n=1）。
在澳大利亚，代表服务使用者、提供者和资助者之间共识的酒精和其他药物治疗服务的绩效衡量标准侧重于展示对公共资金的问责制、改善服务以及向未来的服务使用者和更广泛的社区传达关键成功衡量标准。
