PROVIDER AND CLIENT ADHERENCE IN ALCOHOL ABUSE TREATMENT

提供者和客户对酒精滥用治疗的依从性

• 批准号: 6224282
• 负责人: CHING-TO A MA
• 金额: $ 16.3万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-05-01 至 2003-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6224282
• 关键词: alcoholic beverage consumption; alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; behavioral /social science research tag; drug /alcohol abstinence; human data; human therapy evaluation; therapy compliance

APPLICANT'S ABSTRACT: Public treatment programs for treatment of substance abuse are increasingly being held accountable for their outcome and cost performance. In some cases, funding is partially conditioned on the attainment of cost or performance targets, employing similar tactics to those used by private managed care organizations. In an earlier NIDA-funded project, we studied how Maine's Performance-Based Contracting (PBC) system affected public agency performance as reported to the state funding authority, and the effectiveness of substance abuse treatment at the client level. In this R21 application, we request two years of funding to pursue questions raised in that earlier research related to the veracity of reports in the state data system, and to the determinants of client continuation and completion of treatment. We use already collected data from 1994-1998, including a new data set collected in 1996, but not yet analyzed, to pursue the following specific aims: 1. Compare the reporting practices of clinicians in the state data system and in the field data collected by the investigators based on clinical records. A number of performance measures, such as frequency of use before admission and at discharge, abstinence, progress during treatment, and reduction in use will be defined and compared. We will test for any systematic bias in reporting, a behavior we label "gaming." 2.Analyze the determinants of gaming as defined in Aim 1. A set of hypotheses will be developed to distinguish between gaming as an altruistic response to perceived client need and a financial incentive response by clinicians. Use the field data set to study the visit-by-visit decisions by clients and providers to continue treatment. Test the effects of financial incentives, including PBC, on provider and client behavior related to retention in treatment.

申请人摘要：物质处理的公共处理计划 虐待行为越来越多地被追究后果和代价责任 性能 在某些情况下，供资部分取决于 达到成本或性能目标，采用类似的策略， 由私人管理的护理机构使用。 在早期的NIDA资助的 项目，我们研究了缅因州的绩效合同（PBC）系统 影响了向国家拨款当局报告的公共机构业绩， 以及药物滥用治疗在客户层面的有效性。 在 在R21申请中，我们要求两年的资金来解决问题， 在早些时候的研究中提出的与报告的真实性有关的问题， 国家数据系统，并决定客户端的延续和 完成治疗。 我们使用已经收集的1994-1998年的数据， 包括1996年收集的新数据集，但尚未分析， 具体目标如下： 1.比较国家数据系统中临床医生的报告实践， 研究者根据临床记录收集的现场数据。 一 性能指标的数量，如入院前使用频率， 出院时，戒断、治疗期间进展和减少使用将 定义和比较。 我们将测试报告中的任何系统性偏倚， 我们称之为“游戏”的行为" 2.分析目标1中定义的游戏决定因素。 一组假设 将被开发来区分游戏作为一种利他主义的反应， 感知客户需求和临床医生的经济激励反应。 使用 实地数据集，以研究客户的逐个访问决定， 提供者继续治疗。 测试财政激励措施的效果， 包括中国人民银行在内的机构，就与 治疗