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[ Recorded presentation ] Recorded presentation

Organizational and market-based approaches to substance abuse treatment: Are they related to retention of substance abuse clients?

Shoou-Yih Daniel Lee, PhD1, Joseph P. Morrissey, PhD2, Alan R. Ellis, MSW3, and Kathleen C. Thomas, MPH, PhD2. (1) Department of Health Policy and Administration, University of North Carolina at Chapel Hill, 1101 McGavran-Greenberg Hall, CB# 7411, Chapel Hill, NC 27599-7411, 919/966-7770, sylee@email.unc.edu, (2) Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, 101 Conner Dr. Ste.302, Willowcrest Bldg., CB#3386, Chapel Hill, NC 27599-3386, (3) Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, 725 Airport Road, Chapel Hill, NC 27599-7590

Research has shown that completion of treatment is positively related to the clinical outcomes of substance abuse individuals. Retention of clients in the substance abuse treatment program, however, has been problematic, particularly for those with co-occurring mental health and physical health disorders. Despite the continuous advocacy of policy-makers, practitioners, and researchers for integrated treatment, the delivery of care in substance abuse and mental and physical health remains largely separate, partly due to parallel funding streams and divergent treatment philosophies in those care delivery systems. This study is intended to compare two alternative strategies of service integration in substance abuse treatment—one organizational and the other market-based—in terms of their relationships with client retention in outpatient substance abuse treatment agencies.

Our unit of analysis is the treatment agency. The sample consists of outpatient substance abuse treatment (OSATs) agencies that participated in the 1999 National Drug Abuse Treatment System Study (NDATSS) (n=724). The main independent variable indicates whether integrated services are provided on-site within the organizational boundaries of the treatment agencies or through contracts with external providers in the local market. The dependent variables include the retention rate of substance abuse clients (i.e., the treatment completion rate) and the average length of treatment.

Preliminary results indicate significant variation in how services are provided among OSATs. Both OLS and logistic regression will be conducted to further examine whether strategies of service provision are related to client retention.

Learning Objectives:

Keywords: Substance Abuse Treatment, Service Integration

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.

[ Recorded presentation ] Recorded presentation

Treatment Entry and Retention

The 132nd Annual Meeting (November 6-10, 2004) of APHA