Abstract for: Using System Dynamics to Plan Investment in Alcohol Services
The authors developed a Dynamic Whole System Model of Alcohol Harm Reduction for the England Department of Health, to support local commissioning of alcohol related services. The project used group model building, based on the best evidence available. It is intended to help local primary care commissioners reduce hospital admissions attributable to alcohol. The main “high impact” interventions incorporated are ‘brief advice’ in Primary Care, the employment of Alcohol Health Workers in hospital, and Specialised Treatment. The key output measures are hospital admissions and costs. The model uses four consumption groups (Abstainers; Lower Risk; Increasing Risk; Higher Risk) including ‘binge’ and ‘dependent’ drinkers in more than one state. Each state has a differing propensity for hospital admissions. The model provides a dynamic cost analysis; as interventions move people between states hence changing their risk of admission to hospital. The model contains a set of policies parameterised by the Department of Health, but also allows for local settings. The work relates to the search for consistent and cohesive policies by which central government can guide local actions. The approach of using dynamic models goes beyond action lists for guidance and allows localities to learn what will work for them.