Gerstein DR, Johnson RA, Qian J.
AHSR FHSR Annu Meet Abstr Book. 1994; 11: 91-2.
National Opinion Research Center, Washington, DC 20036.
PROBLEMS AND OBJECTIVES. This paper presents the first stage of findings from a recently completed study of outcomes of treatment in a representative sample of providers in the State of California. These data describe differences among providers of different types of treatment in preparation for analyzing the effectiveness and cost-benefits of treatment. DATA AND METHODS. We drew a multistage probability sample of 104 drug and alcohol treatment providers who receive funding from one of the largest States in order to evaluate the effectiveness of programs in each of four alcohol/drug treatment modalities: social model recovery houses (SOC); methadone (METH); nonmethadone outpatient (OP); and residential (RES--not social model). Data were obtained from providers by means of personal interviews with program directors performed in 1992-93. Data from a random sample of participants discharged from these providers during October 1991-September 92 were obtained from records, and followup personal interviews were conducted during 1993, 6-24 months after discharge. Approximately 3,000 records were abstracted and 1,900 followup interviews obtained. Providers were characterized on a number of major dimensions which distinguished modality types. Results were weighted to reflect numbers of participants, in view of the large differences in patient flow between providers. The following measures were designated for subsequent use in evaluating differences between providers in yielding desirable outcomes of treatment. Results on outcomes of treatment will be released June 1, 1994. RESULTS AND CONCLUSIONS. Organizational stability--On average, METH participants are served by key personnel with longer organizational tenures than participants in other strata. There were no significant differences between modalities in experiencing signficant organizational change in the recent past. Staffing levels -- On average, participants in RES are served by more total staff than participants in other kinds of programs. However, METH participants are served by substantially more medical staff: OP and RES participants by appreciably more nonmedical clinicians (counselors, social workers, rehabilitation specialists) and administrators; and SOC programs are remarkable for their high levels of volunteer staffing. Staff turnover -- Overall turnover per staff person is highest in OP (37% of staff) and lowest in METH (17% of staff). Physical plant -- Participants in SOC are especially likely to be served in provider-owned (versus rented) space, with high market values and low levels of crowding. Financial indicators -- METH participants tend to be served by providers who make relatively large investments in staff training, who receive relatively small revenues per participant, who have relatively high percentages of participants who are unable to pay half or more of the cost of treatment, and who have little or no public or private insurance. Participants in RES are more likely to be served by providers with high total revenues and high average revenues per participant. ORGANIZATIONAL GOALS AND POLICIES. Participants in SOC and METH are most likely to set their own treatment goals. Participants in SOC and RES are more likely to have access to voluntary (no charge) alumni groups sponsored by the provider. COLLECTION AND REPORTING OF FOLLOW-UP DATA. Participants in METH are less likely than others to be followed up for outcome status. METH providers who did collect follow-up data relied more heavily upon telephone and personal interviews and less heavily upon outside consultants than follow-up data collectors in other modalities. IMPLICATIONS FOR AUDIENCE: The significance of provider characteristics in relatiion to outcomes of treatment and controls and incentives available to consumers and payers for treatment will be discussed.
Publication Types:
Keywords:
- California
- Humans
- Interviews as Topic
- Motivation
- Physicians
- Postnatal Care
- therapy
- hsrmtgs
Other ID:
UI: 102212079
From Meeting Abstracts