title: Following the money: Mapping the sources and funding flows of alcohol and other drug treatment in Australia.
abstract: The structures of health systems impact on patient outcomes. We present and analyse the first detailed mapping of who funds alcohol and other drug (AOD) treatment and the channels and intermediaries through which funding flows from the funding sources to treatment providers.
  
  
  
  The study involved a literature review of AOD treatment financing and existing diagrammatic representations of the structure of the Australian health system. We interviewed 190 key informants to particularise the AOD treatment sector, and undertook two case examples of government funded non-government organisations providing AOD treatment.
  
  
  
  Funding sources include the Australian and state and territory governments, philanthropy, fund-raising and clients themselves. While funding sources align with the health sector generally and the broader social services sector, the complexity of flows from source to treatment service and the number of intermediaries are noteworthy. So too are the many sources of funding drawn on by some treatment providers. Diversification is both beneficial and disadvantageous for non-government treatment providers, adding to administrative workloads, but smoothing the risk of funding shortfalls. Government funders benefit from sharing risk.
  
  
  
  Circuitous funding flows multiply the funding sources drawn on by services and put distance between the funding source and the service provider. This leads to concerns over lack of transparency about what is being purchased and challenges for the multiply funded service provider in maintaining programs and service models amid multiple and sometimes competing funding and accountability frameworks. [Chalmers J, Ritter A, Berends L, Lancaster K. Following the money: Mapping the sources and funding flows of alcohol and other drug treatment in Australia. Drug Alcohol Rev 2016;35:255-262].
authors.affiliation: Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales Australia, Sydney, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Chalmers
authors.affiliation: Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales Australia, Sydney, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Ritter
authors.affiliation: Centre for Health and Social Research, Australian Catholic University, Melbourne, Australia.
authors.forename: Lynda
authors.initials: L
authors.lastname: Berends
authors.affiliation: Drug Policy Modelling Program, National Drug and Alcohol Research Centre, University of New South Wales Australia, Sydney, Australia.
authors.forename: Kari
authors.initials: K
authors.lastname: Lancaster
mesh_terms: D000437:Alcoholism / Q000191:economics / Q000534:rehabilitation*; D001315:Australia; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration; D005380:Financing, Government; D061889:Healthcare Financing; D006801:Humans; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation*
keywords: Australia; alcohol and other drug treatment; funding flows; sources of funding