Substance abuse treatment organizations as mediators of social policy: slowing the adoption of a congressionally approved medication.
Substance abuse treatment organizations as mediators of social policy: slowing the adoption of a congressionally approved medication.
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药物滥用治疗组织作为社会政策的调解者：减缓国会批准的药物的采用。
DOI：
10.1007/s11414-008-9132-4
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Reif,Sharon
中科院分区：
文献类型：
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作者：
Wallack,StanleyS;Thomas,CindyParks;Martin,TimothyC;Chilingerian,Jon;Reif,Sharon
大多数药物滥用治疗发生在门诊治疗中心，需要了解是什么促使组织采取新的治疗方式。Tichy的组织框架由三个相互交织的内部系统（技术，文化和政治）组成，用于解释治疗组织缓慢采用丁丙诺啡，一种阿片类药物依赖的新药。主要数据是从海洛因使用者人数最多的十个大都市地区中的四个药物滥用治疗组织收集的。只有约五分之一的人提供丁丙诺啡。在我们的多变量模型中，所有三个内部系统都是丁丙诺啡采用的重要决定因素。然而，文化系统，衡量对药物的态度，是一个必要的条件。旨在鼓励采用循证业绩衡量标准的卫生政策通常侧重于组织的技术系统。这些研究结果表明，如果这些政策包含对所有三个内部系统的理解，它们将更加有效。
Most substance abuse treatment occurs in outpatient treatment centers, necessitating an understanding of what motivates organizations to adopt new treatment modalities. Tichy’s framework of organizations as being comprised of three intertwined internal systems (technical, cultural, and political) was used to explain treatment organizations’ slow adoption of buprenorphine, a new medication for opiate dependence. Primary data were collected from substance abuse treatment organizations in four of the ten metropolitan areas with the largest number of heroin users. Only about one fifth offered buprenorphine. All three internal systems were important determinants of buprenorphine adoption in our multivariate model. However, the cultural system, measured by attitude toward medications, was a necessary condition for adoption. Health policies designed to encourage adoption of evidence-based performance measures typically focus on the technical system of organizations. These findings suggest that such policies would be more effective if they incorporate an understanding of all three internal systems.