Racial/Ethnic Differences in the Quality of Substance Abuse Treatment

描述（由申请人提供）：酒精和其他药物障碍的治疗已被证明是有效的，但以前的研究表明，接受的治疗质量可能会因客户的种族/民族而异。本研究的目的是增加我们对物质使用障碍治疗质量的种族/民族差异的理解。具体而言，本研究旨在：1）检查是否存在物质滥用治疗质量指标的种族/民族差异。广泛采用的门诊药物滥用治疗质量指标措施，治疗启动和参与的华盛顿圈绩效措施，将用于评估治疗质量。2)测试是否客户，设施和社区水平的治疗开始和参与的预测因素因客户的种族/民族而异; 3）评估种族/民族是否调节治疗参与和随后的治疗结果之间的关系，特别是急诊科就诊和戒毒入院。这项研究将使用2006年马萨诸塞州公共资助的门诊药物滥用治疗服务的管理数据。这些数据将与全州急诊科的数据联系起来。为了实现前两个目标，将采用多级回归来解释客户的启动和参与状态的设施内相关性。为了实现第三个目的，将采用生存期（至事件发生时间）分析。结果将在门诊治疗指数访视后的一年内进行测量，控制客户，设施和社区因素。进一步了解治疗质量中的种族/民族差异，可以为各州和项目提供方法，以提高来自不同背景的客户的治疗质量，并获得更好的治疗结果。

DESCRIPTION (provided by applicant): The treatment for alcohol and other drug disorders has been shown to be effective, yet previous research suggests that the quality of treatment received may differ based on client's race/ethnicity. The goal of this study is to increase our understanding of racial/ethnic differences in the quality of treatment for substance use disorders. Specifically, this study aims to: 1) Examine whether racial/ethnic differences in quality indicators of substance abuse treatment exist. The widely adopted quality indicator measures for outpatient substance abuse treatment, the Washington Circle performance measures of treatment initiation and engagement, will be used to assess treatment quality. 2) Test whether client-, facility-, and community-level predictors of treatment initiation and engagement differ by clients' race/ethnicity; 3) Evaluate whether race/ethnicity moderates the relationship between treatment engagement and subsequent treatment outcomes, specifically emergency department visits and detoxification admissions. This study will use administrative data from Massachusetts' publicly-funded outpatient substance abuse treatment services in 2006. The data will be linked with data on emergency department visits across the state. To accomplish the first two aims, multilevel regressions will be employed to account for within-facility correlations of clients' initiation and engagement status. To accomplish the third aim, survival (time-to-event) analyses will be employed. The outcomes will be measured in the year following the index visit to outpatient treatment, controlling for client-, facility-, and community-level factors. Furthering our understanding on racial/ethnic disparities in treatment quality could offer ways for states and programs to improve treatment quality for clients from diverse backgrounds and lead to better treatment outcomes.