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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

基本信息

批准号：
6509407
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
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-05-01 至 2004-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6509407
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

项目摘要

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：针对物质治疗的公共治疗方案越来越多的人要求虐待行为对其结果和成本负责性能。在某些情况下，资金的部分条件是实现成本或绩效目标，采用与以下策略类似的策略由私人管理的护理组织使用。在早些时候由NIDA资助的项目中，我们研究了缅因州的基于绩效的合同(PBC)系统向国家资助当局报告的受影响的公共机构业绩，以及在客户一级进行药物滥用治疗的有效性。在……里面这份R21申请，我们要求两年的资金来追查问题在早期的研究中提出了关于报告的准确性的问题状态数据系统，以及客户延续的决定因素和完成治疗。我们使用了1994-1998年间已经收集的数据，包括1996年收集但尚未分析的一组新数据，以继续以下是具体目标： 1.比较临床医生在国家数据系统中的报告做法和在现场，调查人员根据临床记录收集数据。一个考绩指标的数量，如入院前的使用频率和在出院、禁欲、治疗中的进展和减少使用时将被定义和比较。我们将测试报道中的任何系统性偏见，我们称之为“游戏”的行为。 2.分析目标1中定义的博弈的决定因素。一组假设将被开发来区分游戏作为利他主义对感知到的客户需求和临床医生的财务激励反应。使用现场数据集，用于研究客户和客户的逐个访问决策提供者继续接受治疗。测试财务激励的效果，包括PBC，关于提供商和客户与保留有关的行为治疗。