Drug and Alcohol Review (1997) 16, 205-206

EDITORIAL

M.axi.'mizin the opportunity for a national m l m m u m aata set

The need for meaningful and comparable national data on people receiving alcohol and other drug treatment has been frequently called for by those seeking and providing funding for intervention pro- grammes, research, and the development of policy. The need for improved information systems in treat- ment services has been recently highlighted by the UK Task Force to Review Services for Drug Misuers [1]. There is reason to be optimistic that the time is fight to successfully implement a national minimum dataset in Australia.

There are no extant models of routine data collec- tions in drug treatment services that can easily or appropriately be taken up for use in Australia. We have recently reviewed the data systems currently operating across Australia as part of a project funded by the Commonwealth Department of Health and Family Services. This included an examination of current data collection instruments and health management policies, and an exploration of the feasibility of a national minimum dataset for alcohol and other drug services.

The Australian data collection and management systems appear to be in a constant state of re- development. Western Australia, South Australia and Victoria are presently modifying their central- ized collection procedures. Comprehensive data col- lection and standardization procedures are not implemented in the remaining State and Territory alcohol and other drug services. Not surprisingly, this review revealed national and regional disparities in the format, content, recording procedures and policy regarding data sharing across the sectors of service. The data collected, however, generally con- tains the same client and service delivery information that would be required to develop a national mini- mum dataset.

It is a propitious time for the development of a national alcohol and other drug minimum dataset in Australia. There have been moves towards health outcomes and evidence-based interventions [2] as an explicit part of service purchasing agreements, and the implementation of the National Health Infor- mation Agreement in 1993. The move to replace Commonwealth cost-share funding for particular programs with broad band fimding for public health activities has also heightened the need for effective monitoring of clients with alcohol and other drug problems. Armed with this sound evidence, services will be able to more confidently argue their case for enhanced funding.

The National Health Information Agreement aims to improve co-operation in the development, collection and exchange of data, and to improve access to uniform health information by community groups, health professionals and government and non-government organizations. An activity under the agreement is the ongoing development of the National Health Data Dictionary [3]. This Dictionary is recognized under the agreement as the authorita- tive source of data definitions. Its implementation will enable the comparison of health information across all sections at a national level.

The value of developing additional data definitions relevant to the alcohol and other drug sector are manifold. The primary advantage is that it will not require development and provision of iden- tical soft and hardware; therefore, service providers with very different needs and skills will not be required to use identical systems. Once the items of a minimum dataset are agreed on, the agencies will only need to use the dictionary definition of the existing data items, e.g. the same way of deter- mining age and employment status.

0959-5236/97/030205-02 © Australian Professional Society on Alcohol and Other Dlalgs

206 Editorial

The development of the alcohol and other drug specific items, such as "primary drug problem" will be conducted under the auspices of the National Health Information Work Program. This will en- sure that the development has a national focus, involves broad consultation, and uses agreed stan- dams of data definition. An important aspect of this development is the use of related activities such as the National Community Health Accreditation Standards Program (CHASP) to assist in monitor- ing the standard of information system quality assur- ance processes.

The overwhelming majority of Australian alcohol and other drug service providers currently collect the 15-20 items that we envisage would be included in a minimum dataset. The remaining issues to be dealt with include: the development of consensus on the definition of the alcohol and other drug specific items; the items to be included in the minimum dataset; agreement by service providers to utilize the dictionary definition of their current data items and to provide (paper or electronic) summaries of the data to their state and territory peak government bodies; and the agreement of those peak bodies to share the data across other sectors of health service with the appropriate privac 3, protection.

The National Health Data Diclionary offers the most expedient and efficient mechanism for devel- oping information linkage and transfer across a broad range of alcohol and other drug treatment settings. Fnrthermore, the inclusion of relevant alcohol and other drug items in the dictionary com- plements the long-term objective of establishing a periodic national collection of alcohol and other drug treatment data. This would fimit the need for one-day censuses. It would also assist initiatives such as the Illicit Drug Reporting System, as the data

collected in hospitals would be comparable to that in drug treatment agencies. Participation in such a process generally strengthens communication between specialist and generalist, and primary and secondary service providers for alcohol and other drug clients as they would be collecting comparable data.

Uniform data standards underlie the quality assur- ance process and underpin the evolution of output- based funding and outcome-orientated evaluation. It has long been mooted that systematic evaluative mechanisms will become a reality of funding in governmental and non-government settings. The development of national consensus on the definition of data relevant to alcohol and other drug clients and working towards the adoption of a minimum dataset prior to the enforcement of stricter forms of accountabifity will enable our field to prepare for the emerging trends in health service provision.

JAN COPELAND & JUDY RANKIN National Drug and Alcohol Research Centre University of New South Wales, Sydney, NSW 2052, Australia

References

[1] The Task Force to Review Services for Drug Mis- users. Report of an independent review of drug treat- ment services in England. London, Department of Health, 1996.

[2] Maynard A. Evidence-based medicine: an incomplete method for informing treatment choices. Lancet 1997; 349:126-8.

[3] National Health Data Committee. National health data dictionary, Version 5.0. Canberra, Australian Institute of Health and Welfare, t996.