Measuring performance of treatment services: what is important to Aboriginal clients?
The measurement of the performance of non-government drug treatment services is currently dominated by measures of output and process. This is inconsistent with policy and literature which recommends that patient-reported outcomes and experience measures be used to measure performance. There has been little research on the views of clients to understand what is important to measure. This study aimed to explore what measures of performance are important to clients, and if the views of Aboriginal clients differed to non-Aboriginal clients.
Five focus groups were held with clients of drug treatment, with two of the groups specifically for clients who identified as Aboriginal. The focus group data were analysed, along with data from a priority rating process of measurement types (e.g. outcomes, access) and what specifically should be measured against those measurement types.
All groups rated access measures (e.g. wait time) highly as an important measure of performance. The discussions in the two focus groups with Aboriginal clients emphasised the importance of access to community controlled treatment services and those that accept children, with participant across all groups reporting wait time and eligibility requirements as a barrier to access. Participants from the focus groups with Aboriginal clients also reported structural measures (e.g. staffing profile, program content) as important. Participants from these groups highlighted the need for more Aboriginal workers, workers with lived experience, having a strong connection with workers, and the inclusion of cultural components in programs. In contrast, measures of outcomes (e.g. reduced drug use) and experience (e.g. satisfaction) were highlighted as important for participants in the other three groups.
The results suggest that access and structural measures should be prioritised as measures of drug treatment performance to ensure that the monitoring of treatment seeks to improve treatment outcomes for Aboriginal people.