Drug Abuse Treatment System Survey

描述(由申请人提供)：拟议的研究有两个主要目标。首先，我们将确定全国门诊药物滥用治疗单位在多大程度上使用治疗实践，并在几个关键领域提供符合经验确立的护理标准的服务。这些领域包括：治疗持续时间和强度；受助者对初级卫生保健、精神卫生保健和社会服务的使用；艾滋病毒和肝炎预防工作；为妇女和少数族裔提供的特殊服务；美沙酮剂量水平；以及获得治疗的机会。我们将研究这些治疗方法和服务的变化和变化。 第二，我们将确定与治疗单位做法的变化和变化有关的组织因素(例如，单位的管理下的护理安排、所有权、人员配备)。这些因素包括单位：所有权；认证；资金来源和机制--特别是管理型医疗；地点(地理位置和医院等上级组织的位置)；社区人口特征和卫生保健资源；转诊来源；治疗目标/理念；工作人员和客户特征。 为了实现这些目标，我们将在2003年继续进行全国药物滥用治疗系统调查。2003年的数据将使我们了解全国治疗单位(n=600个治疗单位)的主要做法和服务的现状。此外，随着2003年的调查的增加，我们将从1988、1990、1995、1999/2000和2003年具有代表性的门诊非美沙酮和美沙酮单位中获得数据。纳入2003年样本的治疗单位(n=324)中，超过一半的单位已经在1988年、1990年、1995年和2000年参加了NDATSS；1995年和2000年都有489个单位参加了我们的研究。因此，我们将能够在15年内(1988-2003年)监测实践的变化，并对这些变化的决定因素做出因果推断，以便为政策和实践提供信息。简而言之，NDATSS处于有利地位，可以成为监测和分析国家门诊药物滥用治疗系统正在进行的演变的关键信息来源。

DESCRIPTION (provided by applicant): The proposed study has two major goals. First, we will determine the extent to which the nation's outpatient drug abuse treatment units are using treatment practices and providing services that meet empirically-established standards of care in several key areas. These areas include: treatment duration and intensity; clients' use of primary health care, mental health care, and social services; HIV and Hepatitis prevention efforts; availability of special services for women and ethnic minorities; methadone dose levels; and access to treatment. We will examine both variation and changes in these treatment practices and services. Second, we will identify organizational factors (e.g., units' managed care arrangements, ownership, staffing) associated with variation and change in treatment units' practices. These factors include unit: ownership; accreditation; funding sources and mechanisms--especially managed care; location (both geographic location and location in a parent organization such as a hospital); community demographic characteristics and health care resources; referral sources; treatment goals/philosophy; staff and client characteristics. To achieve these goals, we will continue the National Drug Abuse Treatment System Survey (NDATSS) in 2003. The 2003 data will give us a current picture of key practices and services in treatment units across the nation (n=600 treatment units). Further, with the addition of the 2003 survey, we will have data from a representative sample of outpatient non-methadone and methadone units for 1988, 1990, 1995, 1999/2000 and 2003. More than half of the treatment units to be included in the 2003 sample (n=324) have already participated in NDATSS in 1988, 1990, 1995, and 2000; and, 489 units participated in our study in both 1995 and 2000. Thus, we will be in a strong position to monitor changes in practices over 15 years (1988-2003), and to make causal inferences about determinants of these changes to inform both policy and practice. In short, NDATSS is well-positioned to become the critical source of information for monitoring and analyzing the on-going evolution of the nation's outpatient drug abuse treatment system.