Objective. The study addresses two research aims: (1) to examine the extent to which caseload and program characteristics differ across substance abuse outpatient programs with respect to collocation with licensed mental health outpatient clinic programs and (2) to investigate the relationship between collocation and program level service outcomes.
Data source and sample. Data on all substance abuse outpatient clinics licensed by OASAS during a three-year period (N=479) were obtained from the New York State Office of Alcohol and Substance Abuse Services, Client Data System (CDS). Admission and discharge data collected for each individual admitted to a treatment program is paired with data collected at discharge were aggregated at the program level.
Methods. Bivariate analysis (ANOVA and chi-square) were used to compare caseload characteristics of programs by collocation status (not-collocated, organizational collocation, physical collocation, both organizational and physical). Hierarchical multivariate models investigated the association between collocation status and caseload characteristics and service outcomes.
Principal Findings. In multivariate models, caseload characteristics of collocated programs were not substantially different from those of non-collocated programs, with two exceptions; percentage of clients ever treated for mental illness and program ownership. The greater the percentage of clients ever treated for mental illness the more likely the program was collocated. Programs with local government ownership were highly likely to be collocated when compared with for-profit programs. Service outcomes for collocated programs were found to be on par with those of non-collocated program for nearly all examined variables, all things constant.
Conclusions. At the caseload level, collocated substance abuse programs differ from non-collocated programs only with regard to the percentage of clients ever treated for mental illness and program ownership. However, collocated programs were found to produce service outcomes on par with non-collocated programs. This finding suggests that collocated programs may have adapted substance abuse services to mitigate the expected poorer service outcomes association for persons with co-occurring disorders. Examination of differences between collocated and non-collocated program service delivery with significant differences in service outcomes is suggested for future research. Additionally, implications for program design, program policy, and regulatory authority policy are discussed.
|Advisor:||Warner, Lynn A.|
|Commitee:||Larkin, Heather, McCorry, Frank|
|School:||State University of New York at Albany|
|School Location:||United States -- New York|
|Source:||DAI-B 73/06, Dissertation Abstracts International|
|Subjects:||Behavioral psychology, Social work, Health care management|
|Keywords:||Co-occurring disorders, Comparative effectiveness, Integrated care, Outpaitent clinics, Services integration, Substance abuse treatment|
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