Organizational Capacity for Service Integration in Community-Based Addiction Health Services
Organizational Capacity for Service Integration in Community-Based Addiction Health Services
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DOI：
10.2105/ajph.2013.301842
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发表时间：
2014-04-01
影响因子：
12.7
通讯作者：
Palinkas, Lawrence A.
中科院分区：
文献类型：
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作者：
Guerrero, Erick G.;Aarons, Gregory A.;Palinkas, Lawrence A.
目标。我们检查了在社区成瘾健康服务项目中协调心理健康、公共健康和艾滋病毒检测的准备情况的相关因素。我们分析了2011年从加利福尼亚州洛杉矶县公共资助的成瘾健康服务治疗项目中收集的客户和项目数据。我们分析了104个项目中14379名客户的样本，使用Logistic回归分析了与精神卫生和公共卫生提供者进行服务协调的几率。我们进行了单独的分析，以检查每个项目中接受艾滋病毒检测的客户的百分比。对变革的激励准备和组织氛围与心理健康和公共卫生服务的协调几率较高相关。具有专业认证的项目与精神卫生服务协调的几率更高，而接受公共资金和美沙酮的项目和住宿项目(与门诊患者相比)接受协调HIV检测的客户比例更高。这些发现为激励准备、组织环境、外部监管和资金在提高成瘾健康服务计划发展综合护理的能力方面的作用提供了证据基础。
Objectives. We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs.Methods. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program.Results. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing.Conclusions. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care.