SUBSTANCE ABUSE

药物滥用

• 批准号: 2376074
• 负责人: CHING-TO A MA
• 金额: $ 4.98万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-03-01 至 1999-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2376074
• 关键词: behavioral /social science research tag; clinical research; health care cost /financing; health care policy; health care service evaluation; health system agency; mental health services; organized financing; substance abuse related disorder

This project will study the effect of the ADAMH block grant program on state substance abuse spending by analyzing spending data from the fifty states between fiscal years 1984-96. A central question about the block grant form of intergovernmental aid is whether states spend the funds on the intended services, or whether they use budgetary strategies to appear to be in compliance with maintenance-of-effort provisions but in effect reallocate block grant funds away from substance abuse services. The investigators' preliminary study of six years of state substance abuse agency spending suggests that the ADAMH block grant has stimulated state spending, but this effect may be only since 1990, and differs by state. Given changes in the block grant ending for substance abuse in 1993, the continued importance of the block grant as a source of funding for state agencies in substance abuse, and the heightened interest in block grants across the board in the "new, new federalism," careful study of the ADAMH block grant experience is warranted. Interest in the impact of the ADAMH block grant on stale spending extends beyond the substance abuse community to those concerned with intergovernmental relations and public funding for social programs. This project will: l. Document federal block grant requirements and enforcement efforts over the period of study. 2. Conduct an econometric investigation of the effect of block grant funding on state agency spending. Block grant formula changes in 1989-1992 and in 1993 yield exogenous changes in the key independent variable of interest. We will test an implication of median voter theory that an increase in block grant funding will have an effect on substance abuse funding equal to an increase in state per capita income. In addition, we will test the following hypotheses relevant to policy towards substance abuse services funding: H1: A one dollar increase in federal block grant funding increases state spending by one dollar. H2: Increased federal enforcement of block grant regulations including maintenance-of-effort regulations is associated with a larger impact of block grants on state spending. H3: States in which the substance abuse agency is part of the mental health agency will increase substance abuse spending less in response to an increase in federal spending in comparison to states in which the substance abuse agency is not part of the mental health agency. H4: States in which the block grant makes up a larger share of state spending will increase their spending more in response to block grant funding in comparison to states in which the block grant is a smaller share of state funds. 3. Use state block grant reports and discussions with state agency personnel in a subset of states to assess qualitatively whether federal regulations have been successful in influencing the composition of state spending within categories of service, and for target populations.

该项目将研究 ADMH 整笔拨款计划对 通过分析五十个国家的支出数据来说明药物滥用支出 1984-96 财政年度期间的各州。关于区块的一个核心问题 政府间援助的赠款形式是各国是否将资金用于 预期的服务，或者他们是否使用预算策略来出现 遵守有效的维持努力规定 将整笔拨款资金从药物滥用服务中重新分配出去。这 调查人员对六年国家药物滥用情况的初步研究 机构支出表明 ADAMH 的整笔拨款刺激了国家 支出，但这种影响可能只从 1990 年开始，并且因州而异。 鉴于 1993 年针对药物滥用终止的整笔拨款的变化， 整笔赠款作为国家资金来源的持续重要性 药物滥用机构以及对整笔拨款的兴趣浓厚 全线在“新、新联邦制”中认真研究ADAMH 集体拨款经验是有保证的。对 ADMH 影响的兴趣 对陈旧支出的整笔拨款超出了药物滥用社区的范围 致那些关心政府间关系和公共资助的人们 社会计划。 该项目将： 湖记录联邦整笔拨款要求和执行工作 学习期间。 2. 对整笔拨款的效果进行计量经济学调查 为国家机构支出提供资金。 1989-1992 年整笔拨款公式的变化 1993 年，关键自变量发生了外生变化 兴趣。我们将检验中位选民理论的含义： 增加整笔拨款资金将对药物滥用产生影响 资金相当于国家人均收入的增加。此外，我们 将测试以下与实质政策相关的假设 滥用服务资金： H1：联邦整笔拨款增加一美元，州政府就会增加 花费一美元。 H2：联邦加大对整笔拨款法规的执行力度，包括 维持努力规定与更大的影响有关 国家支出的整笔拨款。 H3：药物滥用机构是精神病机构一部分的国家 卫生机构将减少药物滥用支出以应对 与各州相比，联邦支出有所增加 药物滥用机构不属于精神卫生机构。 H4：整笔拨款占州比例较大的州 支出将增加更多支出以应对整笔拨款 与整笔赠款较小的州相比提供的资金 国家资金份额。 3. 使用州整笔拨款报告以及与州机构的讨论 部分州的人员定性评估联邦是否 法规成功地影响了国家的构成 服务类别内以及针对目标人群的支出。