5089.0: Wednesday, November 15, 2000 - 1:42 PM

Abstract #17660

Organizational correlates of access to outpatient drug abuse treatment on demand

Peter D Friedmann1, Stephenie C Lemon, Michael D Stein, and Tom A D'Aunno. (1) Departments of Medicine and Community Medicine, Brown University, Providence, RI, 401-444-3347, pfriedmann@lifespan.org

Purpose: To determine the organizational correlates of access to treatment on demand (TOD) in outpatient drug abuse treatment (ODAT) programs.

Methods: We analyzed the National Drug Abuse Treatment System Survey (NDATSS), a panel study of national sample of ODAT programs from 1988, 1990, and 1995. Further analyses will include data from the 1999-2000 wave (available 5/00). The dependent variable, TOD, was defined as the director's report of an average wait of less than 48 hours for treatment entry. Directors and clinical supervisors reported characteristics of the programs. Logistic regression models evaluated the correlates of TOD.

Results: Of 589 programs with wait time data, 66% reported TOD. Preliminary models suggest that private-for-profit programs, programs facing more cost competition, and programs that serve more alcohol-abusing patients are more likely to offer TOD. TOD is less available in methadone programs, programs with higher caseloads, and programs that provide more indigent care, as measured by the percentage of patients who are uninsured or who pay a reduced fee. Survey wave, the extent of criminal justice referrals, and managed care involvement (as measured by the percentage of HMO/PPO patients, of patients subject to prior authorization, and of patients subject to concurrent review) had no detectable association with the availability of TOD.

Conclusions: Private-for-profit, chemical dependency programs appear likely to provide treatment on demand. In contrast, programs that provide more indigent care or offer methadone treatment have longer wait times before treatment entry.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1) Appreciate the issues surrounding provision of addiction treatment on demand. 2) Understand the organizational characteristics of outpatient drug abuse treatment programs associated with greater access to treatment on demand

Keywords: Substance Abuse Treatment, Access

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA