Relationship between drug treatment services, retention, and outcomes
Relationship between drug treatment services, retention, and outcomes
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DOI：
10.1176/appi.ps.55.7.767
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发表时间：
2004-07-01
影响因子：
3.8
通讯作者：
Anglin, DM
中科院分区：
文献类型：
--
作者：
Hser, YI;Evans, E;Anglin, DM
目的：本纵向研究通过路径分析来检验社区药物治疗项目中患者治疗过程与结果之间的关系。方法：对加州13个县36个门诊戒毒和住院治疗项目的1939例患者在入院、出院、入院后3个月和入院后9个月进行评估。进行通径分析，将治疗前三个月接受的服务的数量和质量与治疗保留和九个月随访的结果联系起来。如果患者在随访评估前至少30天没有使用药物，没有参与犯罪活动，并且生活在社区中，则确定患者有良好的结果。路径分析控制了患者的基线特征。结果：更高的服务强度和满意度与治疗完成或更长时间的治疗保留呈正相关，而治疗保留又与良好的治疗结果相关。问题严重程度越高的患者接受的服务越多，对治疗的满意度也越高。无论患者是在门诊戒毒项目还是住院项目中接受治疗，这些模式都是相似的。结论：过程测量（即更高水平的服务强度、满意度、治疗完成度或保留度）与治疗结果之间的正相关关系强烈表明，治疗过程中这些关键要素的改进将改善治疗结果。
Objective: This longitudinal study conducted path analyses to examine the relationships between treatment processes and outcomes among patients in community-based drug treatment programs. Methods: A total of 1,939 patients from 36 outpatient drug-free and residential treatment programs in 13 California counties were assessed at intake, discharge, three months after admission, and nine months after admission. Path analyses were conducted to relate the quantity and quality of services that were received in the first three months of treatment to treatment retention and outcomes at the nine-month follow-up. Patients were determined to have a favorable outcome if for at least 30 days before the follow-up assessment they did not use drugs, were not involved in criminal activity, and lived in the community. The path analyses controlled for patients' baseline characteristics. Results: Greater service intensity and satisfaction were positively related to either treatment completion or longer treatment retention, which in turn was related to favorable treatment outcomes. Patients with greater problem severity received more services and were more likely to be satisfied with treatment. These patterns were similar for patients regardless of whether they were treated in outpatient drug-free programs or residential programs. Conclusions: The positive association between process measures-that is, greater levels of service intensity, satisfaction, and either treatment completion or retention-and treatment outcome strongly suggests that improvements in these key elements of the treatment process will improve treatment outcomes.