HOMELESS DRUG ABUSE--SERVICE USE, COSTS, CONSEQUENCES

描述：(申请人摘要) 而无家可归人口中滥用药物的流行率是 对他们的服务利用模式和 使用的服务类型(药物滥用、住房或替代服务)，或 关于这些服务所产生的结果。为了解决这一差距，这 该项目提议对400名无家可归的成年男性进行随机抽样研究， 妇女在两年内确定服务使用和地位的预测因素 滥用药物的无家可归者人数的变化。构建在不止一个 四分之一个世纪在研究和服务方面的综合经验 为无家可归的人口提供服务这个团队将测试一种理论 预测药物的服务使用、需求、成本和后果的模型 虐待无家可归人口(SUNCODA)。追随一名非毒品患者的机会 虐待无家可归者对照小组将提供关于 药物使用障碍对人际关系中无家可归者的影响 服务使用模式和状态变化(后果)之间的关系。 从获取组织、融资和管理结构数据 相关服务机构将为这一人群提供机会 调查服务的结构特征如何预测实际 吸毒者与非吸毒者的服务使用情况比较 个人。最后，本研究将比较与以下项目相关的成本 药物滥用和非药物滥用者的治疗。建议数 项目尤其重要，因为它直接针对 在有关服务利用率的文献中有很好的记录空白，更改 在滥用药物的无家可归人口中的地位和费用。结果来自 该项目将对公共政策产生重大影响，包括 指导为有效提供服务而分配资源和 向未来讨论这一疾病的治疗替代方案提供信息 困难的人群。 样本将从各种公共设置中随机选择， 包括过夜庇护所、日间中心和专门的康复 针对无家可归者的方案，以及来自街头地点的方案。全 受试者将在基线上接受采访，每隔一年进行一次 适用于这项研究的工具收集诊断、个人病史、 社会人口学和状态数据(针对每一波进行修改)。研究对象将 在所有三波数据收集中都被要求提交尿液筛查。 所有受试者将被要求提供他们的医疗，精神， 和药物滥用记录，以便机构可以提供有关类型的信息 以及随时间推移的服务使用程度。此外，受试者将参与 在季度报告中详细说明服务使用情况的运行变化 时间到了。将使用详尽的跟踪方法来最大化目标 留存。结构特征(组织、管理和 融资)数据将从服务机构收集，基准为 检查它们对服务使用的影响。

DESCRIPTION: (Applicant's Abstract) While the prevalence of drug abuse in the homeless population is substantial, little is known about their patterns of service utilization and the types of services used (drug abuse, housing, or substitute services), or about the outcomes resulting from these services. To address this gap, this project proposes to study a random sample of 400 homeless adult men and women over two years to identify predictors of service use and status changes in the drug abusing homeless population. Building on more than a quarter of a century of combined experience in research and service provision for the homeless population this team will test a theoretical model that predicts Service Use, Needs, Costs, and cOnsequences for the Drug Abusing homeless population (SUNCODA). The opportunity to follow a non-drug abusing homeless population comparison group will provide evidence about the impact of drug use disorders on homelessness in terms of relationships between service utilization patterns and status change (consequences). Obtaining organizational, financing, and management structure data from relevant service agencies to this population will provide the opportunity to investigate how structural characteristics of services predict actual service use by drug abusing compared to non-drug abusing homeless individuals. Finally, this study will compare costs associated with treatment of drug abusing and non-drug abusing subjects. The proposed project is particularly significant in that it directly addresses well-documented gaps in the literature on service utilization, changes in status, and costs in the drug abusing homeless population. Results from this project will have significant impact on public policy, including guidance of allocation of resources for effective service provision and informing future discussions of treatment alternatives for this particularly difficult population. The sample will be randomly selected from a variety of public settings, including overnight shelters, day centers, and specialized rehabilitation programs for homeless people, as well as from street locations. All subjects will be interviewed at baseline and at one-year intervals with an instrument adapted for this study collecting diagnostic, personal history, sociodemographic, and status data (modified for each wave). Subjects will be asked to submit a urine screen at all three waves of data collection. All subjects will be asked to provide access to their medical, psychiatric, and substance abuse records so that agencies can provide information on type and extent of service use over time. In addition, subjects will participate in quarterly reports to detail changes in functioning an service use over time. Exhaustive tracking methods will be utilized to maximize subject retention. Structural characteristics (organizational, management, and financing) data will be collected from service agencies at baseline to examine their impact on service use.