The 130th Annual Meeting of APHA

3344.0: Monday, November 11, 2002 - 8:45 PM

Abstract #46325

Establishing the feasibility of performance measures for alcohol and other drugs

Deborah W Garnick, ScD1, Margaret T. Lee, PhD2, Mady Chalk, PhD3, David Gastfriend, MD4, Constance M. Horgan, ScD2, Frank McCorry, PhD5, A.Thomas McLellan, PhD6, and Elizabeth L. Merrick, PhD, MSW2. (1) Schneider Institute for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Mailstop 035, Waltham, MA 02454-9110, 781-736-3840,, (2) Schneider Institute for Health Policy, Heller Graduate School, Brandeis University, 415 South Street, Waltham, MA 02454, (3) Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockwall II Building, Suite 740, 5515 Security Lane, Rockville, MD 20852, (4) Addiction Research Program, Massachusetts General Hospital, Back Bay, 388 Commonwealth Avenue, Boston, MA 02115, (5) Clinical Services, NYSOASAS, 501 7th Avenue, New York, NY 10018-5903, (6) Treatment Research Institute, Public Ledger Building, Suite 600, 150 South Independence Mall West, Philadelphia, PA 19106

Development of performance measures for alcohol and other drug (AOD) services has lagged behind development of such measures for many other chronic medical conditions, probably because of the unique social role of alcohol and drug use. In this article, we examine three performance measures for AOD services. These measures, which the Washington Circle Group developed1 and applied to MCOs' administrative data for their commercial enrollees, are: 1) identification, the percent of adult enrollees with AOD diagnoses; 2) initiation, the percent of adults with an inpatient AOD admission or with an index outpatient visit for AOD abuse or dependence and any additional AOD services within 14 days; and 3) engagement, the percent of adults diagnosed with AOD disorders that receive two additional AOD services within 30 days of the initiation of care. We used data from six managed care organizations and one managed behavioral healthcare organization. Across the seven MCOs, the performance measures vary considerably. Identification rates for the MCOs ranged from 0.72 to 1.45 percent of enrollees. Initiation rates ranged from 26 percent in two MCOs to 46 percent in two other MCOs. Engagement rates were more consistent across MCOs with a range of 52 to 65 percent. We conclude that using administrative databases to compare MCOs' performance is feasible, meaningful and informative. Moreover, the key to understanding and using the measures is to consider challenges to performance measurement in several areas: organizational structure of alcohol and other drug services, information available for measurement, and computational issues.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

Presenting author's disclosure statement:
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.

Performance Measures for Substance Abuse: Opportunities and Challenges

The 130th Annual Meeting of APHA