Health Services Research. Lecture Summary

Introduction:
This talk will concentrate on the community perspective for alcohol health services research. Therefore this presentation will mostly focus on help-seeking behavior in community samples, and what predicts help-seeking and where help is sought across a broad array of service settings. Because of the limited length of this presentation, it will not discuss a crucial aspect of health services research, the outcomes and effectiveness of treatment. This presentation will also not discuss the cost-effectiveness of alcohol services because of the complexities of this issue. The presentation defines health services research and the framework for health services research, based on NIAAA's National Plan for Alcohol Health Services Research.

Fundamental Concerns in the Community Perspective for Alcohol Health Services Research:
A fundamental issue in alcohol services research in the community is the low rate of alcohol treatment or help-seeking. Various community studies have shown that only about 10% of individuals with an alcohol disorder or problem drinking will obtain help for drinking within a one-year interval. But large numbers of problem drinkers can be identified from other health and service settings. We know much about the characteristics of individuals with alcohol disorders in specialty treatment settings and who uses these types of services, but we know much less about clients in other health and service settings. Important factors to consider in relations to service use are client characteristics such as gender and illness severity, and a range of access factors. From the system perspective, it is important to consider the organization and financing of care, including multiple providers of care, matching clients to services, and managed care.

Conclusions:
We need to know more how to increase the help-seeking rates by problem drinkers, and more about the impact of changes in organization and financing of alcohol services as well as how to provide services for a broad array of needs. Understanding the community perspective, as well as the treatment program perspective, is critical for policy and program development.