The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65177

Stacy Sterling, MPH, MSW¹, Constance Weisner, DrPH, MSW², and Yun Lu, MA¹. (1) Division of Research, Kaiser Permanente, Northern California, 2000 Broadway, Oakland, CA 94612-2304, 510-891-3614, sas@dor.kaiser.org, (2) Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143

This study examines access to and utilization of substance abuse services in an HMO by adolescents. Particular attention is given to the level of intra-organizational integration, and health plan and extra-organizational coordination on the and their impact on referrals. We map out the system pathways and obstacles to substance abuse treatment, describe the demographic and epidemiologic characteristics of those entering treatment, and examine characteristics (i.e., demographic characteristics, type and severity of substance abuse, age of onset, mental and physical health co-morbidity, educational problems, legal problems, family problems) associated with treatment initiation and retention, with particular attention to variation by age, gender and ethnicity. We examine how medical, mental health, and substance abuse services within the same health care plan, as well as extra-organizational institutions such as schools and the juvenile justice system, interact to produce either access or barriers to substance abuse treatment. We use several data sources (survey interviews with adolescents and their parents, computerized health plan utilization and clinical diagnostic databases, medical chart reviews and qualitative interviews with providers and focus groups with teens and parents) to: 1) identify successful system pathways and potential barriers to treatment access, 2) describe pre-treatment patterns of health service utilization which may facilitate problem identification and referral to treatment, and conversely, examine the degree to which primary care and mental health providers miss opportunities to intervene by not screening, and 3) characterize who successfully enters and remains in treatment, thus identifying those at risk for early dropout.

Learning Objectives:

1.Describe the the system pathways and barriers to substance abuse treatment for adolescents with managed care health coverage, and understand the health care and other human services problems and utilization patterns before treatment.
• Identify the characteristics of those entering treatment (i.e., demographic characteristics, type and severity of substance abuse, age of onset, mental and physical health co-morbidity, educational problems, legal problems, family problems and assess whether system pathways/barriers, retention patterns and problem characteristics vary by gender, ethnicity or age. 3.Identify where and how adolescents are first identified as having substance abuse problems, and describe the process through which they successfully enter treatment.
• Discuss how do organizational and provider relationships between different service clinics, and health plan and extra-organizational coordination impact referrals.

Keywords: Substance Abuse, Adolescent Health

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.