Prospective validation of substance abuse severity measures from administrative data
Prospective validation of substance abuse severity measures from administrative data
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DOI：
10.1016/j.drugalcdep.2006.04.016
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发表时间：
2007-01-05
影响因子：
4.2
通讯作者：
Gabriel, Roy M.
中科院分区：
文献类型：
--
作者：
McCamant, Lynn E.;Zani, Brigid G.;Gabriel, Roy M.
背景资料：随着资助者采用与机构绩效挂钩的支付系统，药物滥用治疗方案中客户的严重程度措施变得越来越重要。最近，根据行政数据制定了两项严重程度衡量标准。本研究验证这些措施，使用前瞻性data.Methods：受试者的药物滥用治疗结果研究（成人或青少年组件）或药物滥用和精神卫生服务管理局医疗补助管理的行为医疗保健和弱势群体项目（成人或青少年化学依赖组件）的参与者。根据进入药物滥用治疗时获得的数据计算严重程度指标。基线严重程度测量包括沿着年龄、性别和人种/种族在逻辑回归模型中预测随访时戒酒。结果：对于成年人，两个数据集中的所有模型的严重程度测量值都具有高度统计学显著性（p < 0.001），表明严重程度较高的成年人在随访时比严重程度较低的成年人更有可能（在许多情况下更有可能）使用酒精，大麻，可卡因或海洛因。对于青少年，严重性措施是非常显着的统计学意义（p < 0.001），大麻在这两个数据集和酒精的Medicaid dataset.Conclusions：基线严重性措施是强大的预测禁欲随访。这些措施，来自常规可用的电子记录，似乎有值得注意的预测有效性。严重性指标可用于行政目的，例如在审查治疗机构的业绩时进行风险调整。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Background: Severity measures for clients in substance abuse treatment programs are becoming increasingly important as funders adopt payment systems linked to agency performance. Recently, two severity measures based on administrative data have been developed. This study validated these measures using prospective data.Methods: Subjects were participants in the Drug Abuse Treatment Outcomes Study (adult or adolescent components) or the Substance Abuse and Mental Health Services Administration Medicaid Managed Behavioral Healthcare and Vulnerable Populations project (adult or adolescent chemical dependency components). Severity measures were calculated based on data obtained at entry into substance abuse treatment. The baseline severity measures were included along with age, gender, and race/ethnicity in logistic regression models predicting abstinence at follow-up for alcohol use. marijuana use, cocaine use, or heroin use.Results: For adults, the severity measures were highly statistically significant (p < 0.001) for all models in both data sets, indicating that adults with higher severity were more likely (and much more likely in many cases) to use alcohol, marijuana, cocaine, or heroin at the follow-up interview than were those with lower severity. For adolescents, the severity measure was highly statistically significant (p < 0.001) for marijuana in both data sets and for alcohol in the Medicaid data set.Conclusions: Baseline severity measures were powerful predictors of abstinence at follow-up. These measures, derived from routinely available electronic records, appear to have noteworthy predictive validity. The severity indicators can be used for administrative purposes such as risk-adjustment when examining treatment agency performance. (c) 2006 Elsevier Ireland Ltd. All rights reserved.