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Organizational Capacity to Eliminate Outcome Disparities under Healthcare Reform

消除医疗改革结果差异的组织能力

基本信息

批准号：
9026799
负责人：
Erick Guerrero
金额：
$ 46.98万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-05-01 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9026799
关键词：
AIDS prevention Address Administrator African American California Caring Client Communities County Data Data Set Development Economics Elements Ethnic Origin Face Funding Goals Grant HIV risk Health Health Care Reform Healthcare Improve Access Incentives Insurance Latino Leadership Los Angeles Low income Measures Mediating Medicaid Mental Health Minority Minority Groups Modeling Nature Organizational Models Outcome Outpatients Performance Phase Play Policies Policy Maker Positioning Attribute Process Provider Public Health Quality of Care Race Readiness Research Role Sampling Services Statutes and Laws Subgroup Substance abuse problem System Testing Underrepresented Minority abstracting addiction base care systems cost design ethnic minority population evidence base health disparity innovation parity prevention service programs public health relevance racial and ethnic response substance abuse treatment theories treatment organization treatment program

项目摘要

Project Summary/Abstract The substance abuse treatment field faces an unprecedented challenge to reduce health disparities among racial and ethnic minority populations. Access to integrated substance abuse, mental health, and HIV prevention care is associated with positive health outcomes and reduced cost. The overall goal of the proposed study is to identify how changes precipitated by the Affordable Care Act (ACA) impact community- based outpatient substance abuse treatment (OSAT) program capacity to expand service delivery in racial and ethnic minority communities and eliminate outcome disparities among African American and Latino clients. The objective for this application is to examine the organizational impact of the current expansion of Medicaid on the capacity of community-based OSAT programs to enhance treatment access and retention among minorities residing in Los Angeles County (L.A.), California by developing and analyzing a panel dataset. Our conceptual framework, grounded in organizational development frameworks investigates the role of organizational capacity (i.e., leadership, readiness for change, Medi-Cal billing) in mediating the effect of Medicaid expansion (referred as Medi-Cal in California) on service delivery (i.e., mental health and HIV prevention services) and on treatment access and retention among African American and Latino clients. In Aim 1 and 2 we will examine baseline data to refine our conceptual model of organizational capacity factors likely to impact the delivery of mental health and HIV prevention services in OSAT programs in racial and ethnic minority communities, prior to ACA enactment. We will resurvey in 2013, 2015 and 2017 the same representative sample of 147 OSAT programs located in minority communities to form a panel data set. These repeated measures of program data will be concatenated with administrative client outcome data (N~10,800 clients) at each data point to examine in Aims 3 and 4 the longitudinal impact of insurance expansion on service delivery in minority communities and rates of access and retention among African American and Latino clients with mental health and HIV risk conditions. The overall public health impact of the proposed study includes identifying promising organizational factors among publicly funded community-based OSAT programs that serve large proportions of low-income minority clients that play a mediating role between the ACA insurance expansion and client-centered process outcomes with the goal of eliminating health disparities.

项目总结/文摘