Overdose Measures Matter

Indicator Profile

Percent of people you serve who report they receive the care and services they need. (If unable to calculate a percentage collect, “Number of people you serve who report they receive the care and services they need”).

Category: Health Access

Audience: Program Implementer

Data Type: Quantitative

Indicator Overview

Description:

Percent (%) of people you serve who report they receive the care and services that they need or the alternative, number of people you serve who report they receive the care and services they need

This indicator is flexible and can be tailored to a program’s unique needs and concerns. Consider the following examples:

  • Ask participants about all care and services that are currently unmet; e.g., “What services do you currently need that are unmet, unattainable, unoffered?”; “Do you receive the care and services you need?”
  • Ask participants about specific care and services that your organization directly provides or is interested in learning more about, e.g., “Are you interested in testing for HIV/Hep C?”; “Do you need assistance with obtaining a government ID or driver’s license?”
  • Ask participants about specific care and services that are currently available in your community, e.g., “Have you seen a medical provider in the last 6 months?”; “Are you interested in learning about medical transportation options?”

Rationale:

By asking participants directly, organizations can help address immediate needs and identify trends and/or larger needs that can be more effectively addressed through future interventions, policy changes or community response. Asking participants directly instead of making assumptions about needs can improve trust.

Pilot sites collecting this indicator can use the data to 1) collaborate with other services in the area, 2) inform coalition and community leadership of gaps that limit access to community services and resources and 3) justify requests for funding.

Related Indicators:

A related indicator to consider is barriers to initiating or engaging in care and services. This can provide insight into the experiences of people with lived and living substance use experience in navigating, accessing and initiating care. Having this additional information can help program implementers identify and leverage resources to address disparities and unmet needs and promote access to care in underserved communities.

Indicator Details

Definitions:

People you serve includes all people who use drugs (PWUD) who participate in or are served by your program. In some cases, you may not know if someone is a person who uses drugs. In this case, you may consider expanding this pool to a) all people served by a specific program or b) all people served by your organization across multiple programs.

Care and services may be defined as a broad range of health, wellness and social services such as harm reduction, medical or behavioral health care, transportation to medical appointments or government offices, help with filling out government forms, peer support, obtaining housing, childcare or education on naloxone use.

Social determinants of health (SDOH) are the conditions people live in that affect their health. Examples of SDOH include having a stable income, access to a good education, living in a safe neighborhood, being part of a strong community and having quality healthcare.1

Receiving the care and services one needs means identifying and removing obstacles that make it hard to access treatment and stay healthy. The elimination of disparities, as well as the removal of financial and life challenges should be at the forefront of prioritizing health equity in overdose prevention programs. Attention should be given to health inequities in all populations.

Ways to Examine the Data:

Numerator: Number of people you serve who indicated via your chosen data collection method that they received the care and services they need

Denominator: Total number of people you serve who participated in your chosen data collection method

  1. Participants Demographics (e.g., race, ethnicity, sex, gender identity, priority population, primary language, housing status, age group) “Who is being served?” Who is not being served?”

  2. Types of care and services “What type of care is offered in your community?” “What care is unavailable or under-utilized in your area?“

Learn more about collecting demographic data. This type of data collection may require specialized training, skill and financial resources.

Data Sources:

  • People served by your program

Data Collection Methods:

  • Point in Time (PIT) Survey
  • Focus groups
  • Program intake survey

Application and Considerations

Suggested Use:

  • To identify unmet needs of program participants
  • To understand whether unmet needs vary by population or communities
  • To identify opportunities to partner with organizations to help meet the needs of the people you serve

Health Access Considerations:

You may want to consider:

  • How will you use this information to improve services for program participants?
  • Do unmet needs vary by participant demographics? Is one population more likely to NOT have their needs met?
  • What services are available in your community? Do people know about them? Are they accessible? Are the staff at these programs friendly to PWUD?
  • What other mechanisms are in place to learn more about what care and services program participants are most in need of?

Evaluation Considerations:

Limitations:

  • Does not address the quality of services available
  • Does not assess clients’ knowledge of what is available
  • Does not address barriers related to receiving care and services

Additional Resources

Examples:

  • Grieb, S. M., Harris, R., Rosecrans, A., Zook, K., Sherman, S. G., Greenbaum, A., … Page, K. R. (2022). Awareness, perception and utilization of a mobile health clinic by people who use drugs. Annals of Medicine, 54(1), 138–149.
    https://doi.org/10.1080/07853890.2021.2022188

References:

  1. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2030. Social Determinants of Health.
    https://health.gov/healthypeople/objectives-and-data/social-determinants-health
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