Impact of COVID-19 on service delivery for an evidence-based behavioral treatment for families involved in the child welfare system.
Impact of COVID-19 on service delivery for an evidence-based behavioral treatment for families involved in the child welfare system.
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COVID-19对服务提供儿童福利系统家庭的基于证据的行为治疗的影响。
DOI：
10.1016/j.jsat.2021.108388
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发表时间：
2021-10
影响因子：
3.9
通讯作者：
Saldana L
中科院分区：
文献类型：
--
作者：
Cruden G;Campbell M;Saldana L
新型冠状病毒 COVID-19 极大地影响了临床服务的提供，特别是药物滥用治疗。家庭积极改善关系 (FAIR) 计划是一项面向行动、循证的行为治疗方法，针对参与儿童福利 (CW) 系统的父母的阿片类药物和甲基苯丙胺障碍。由七名临床医生组成的团队在医疗补助资助的诊所内运作，主要在社区提供服务。 FAIR 关注促进客户参与和临床结果的 FAIR 干预策略的基本机制，迅速调整程序以应对 COVID-19 发作的干扰。这项研究分析了 2019 年 1 月至 2020 年 7 月的行政记录和医疗补助索赔数据，包括 157 名客户和 17,449 项索赔。分析考虑了 2020 年 3 月至 7 月期间出现的 COVID-19。该研究考察了在 COVID-19 爆发之前和之后 FAIR 服务提供的频率和报销金额的变化。尽管每个临床医生的平均每月报销金额没有显着下降，但每个客户的报销金额却大幅下降了 31%（之前：1005 美元 [732 美元]；之后：698 美元 [546 美元]，p < .001）。在 COVID-19 期间，临床医生每月提供服务的天数显着增加（平均值 (sd) = 16.73 (6.33)；20.26 (7.24)，t(127) = −2.70，p < .01）。临床医生的平均病例量保持稳定，客户的平均每月服务收据天数也保持稳定。因此，本研究将 FAIR 远程提供服务时每个客户报销的减少归因于面对面计费服务的消除和会话时长的减少，但不是频率的减少。医疗补助资助的诊所和 FAIR 等基于社区的药物滥用治疗干预措施可以成功地维持和实施药物滥用治疗实践，并进行审慎、快速的调整，以确保家庭在面临背景危机时获得所需的支持。
The novel coronavirus, COVID-19, has dramatically impacted clinical service delivery, particularly substance use treatment. The Families Actively Improving Relationships (FAIR) program is an action-oriented, evidence-based behavioral treatment for opioid and methamphetamine disorders in parents involved in the child welfare (CW) system. A seven-clinician team operates out of a Medicaid-funded clinic, primarily delivering services in the community. Attending to underlying mechanisms of FAIR's intervention strategies that promote client engagement and clinical outcomes, FAIR rapidly adapted procedures in response to COVID-19-onset disruptions. This study analyzed administrative records and Medicaid claims data from January 2019 to July 2020, including 157 clients and 17,449 claims. Analyses considered COVID-19 presence as March–July 2020. The study examined changes in the frequency and reimbursement volume of FAIR service delivery pre- and postonset of COVID-19. Although average monthly reimbursement per clinician did not significantly decline, reimbursement per client significantly declined by 31% (pre: $1005 [$732]; post: $698 [$546], p < .001). Clinicians delivered services on significantly more days per month during COVID-19 (mean (sd) = 16.73 (6.33); 20.26 (7.24), t(127) = −2.70, p < .01). Average clinician caseload size was stable, as was the average monthly service receipt days for clients. Thus, this study attributes reductions in reimbursement per client when FAIR provided services remotely to the elimination of in-person billable services and reductions in session length, but not in frequency. Medicaid-funded clinics and community-based substance use treatment interventions such as FAIR can successfully sustain and implement substance use treatment practices with deliberate, rapid adaptation to ensure that families receive needed supports in the face of contextual crises.
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影响因子：
4.2
作者：
Jones, HE;Wong, CJ;Stitzer, ML
通讯作者：
Stitzer, ML
影响因子：
3.8
作者：
Stewart, Rebecca E.;Adams, Danielle R.;Beidas, Rinad S.
通讯作者：
Beidas, Rinad S.
DOI：
10.1007/s10488-021-01128-4
发表时间：
2021-03-19
影响因子：
2.6
作者：
Maxwell, Colleen A.;Ehrhart, Mark G.;Beidas, Rinad S.
通讯作者：
Beidas, Rinad S.
影响因子：
1.3
作者：
Bischoff, RJ;Hollist, CS;Flack, P
通讯作者：
Flack, P
影响因子：
7.2
作者：
Stirman, Shannon Wiltsey;Baumann, Ana A.;Miller, Christopher J.
通讯作者：
Miller, Christopher J.