Development of a resource allocation formula for substance misuse treatment services

Area of Science:

• Public Health
• Health Economics
• Substance Misuse Services

Background:

• Substance misuse services funding is a significant portion of Public Health expenditure in England.
• Current allocation formulas use activity, performance, and Standardized Mortality Ratio (SMR < 75) for need.
• Deprivation and other measures may offer a more accurate assessment of differential service needs.

Purpose of the Study:

• To develop and assess models for resource allocation in substance misuse services.
• To evaluate the impact of incorporating various needs and supply variables into allocation formulas.
• To determine if a person-based model can better reflect population needs and potentially shift resources.

Main Methods:

• Developed age-standardized and age-stratified (over/under 18s) models predicting costs at Local Authority level.
• Created a person-based model incorporating individual-level cost predictors.
• Assessed the inclusion of needs and supply variables in each model.

Main Results:

• Mean annual estimated cost per English Local Authority was over £5 million, with 83% for drug misuse treatment.
• Models achieved adjusted R-squared values ranging from 0.232 to 0.533.
• The person-based model showed potential for including diverse needs variables and treatment history.

Conclusions:

• Existing resource allocation formulas for substance misuse services can be improved to better reflect population needs.
• A revised person-based formula, incorporating needs and past treatment, is proposed.
• Adoption of the person-based model could lead to resource redistribution towards more deprived areas.