Zarkin Gary A, Dunlap Laura J, Bray Jeremy W, Wechsberg Wendee M
RTI, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA.
J Subst Abuse Treat. 2002 Dec;23(4):261-71. doi: 10.1016/s0740-5472(02)00273-8.
Length of stay in treatment has been found to be a significant predictor of positive post-treatment outcomes, such as decreases in unemployment and crime. However, length of stay may be an incomplete predictor of successful treatment. Surprisingly, few studies have examined whether completing treatment in addition to length of stay is an important factor in explaining positive treatment outcomes. The objective of our study is to examine the effect that treatment completion and length of stay have on post-treatment employment and crime for patients in outpatient drug-free treatment, the largest treatment modality in the United States. We use conditional logit and multiple regression models with program-level indicator variables (fixed effects) to estimate the effect of treatment completion and length of stay on employment and crime controlling for drug use severity, previous treatment history, and other patient demographics. Data are from the National Treatment Improvement Evaluation Study and include 986 adults enrolled in outpatient drug-free programs across the United States. We find that treatment completion and length of stay are significantly related to post-treatment employment. Holding length of stay constant, the occurrence of employment at follow-up among patients who complete their planned treatment is almost 2 times that of patients who do not complete treatment. However, treatment completion did not have a statistically significant effect on the probability of post-treatment crime. Although our results are mixed, these findings suggest that greater attention should be placed on evaluating the importance of both length of stay and treatment completion in treatment outcome studies.
研究发现,治疗时长是治疗后产生积极结果的重要预测指标,比如失业率和犯罪率的下降。然而,治疗时长可能并非成功治疗的完整预测指标。令人惊讶的是,很少有研究探讨除治疗时长外,完成治疗是否是解释治疗积极结果的一个重要因素。我们研究的目的是检验治疗完成情况和治疗时长对美国最大的治疗方式——门诊戒毒治疗患者治疗后的就业和犯罪情况的影响。我们使用带有项目层面指标变量(固定效应)的条件logit模型和多元回归模型,来估计治疗完成情况和治疗时长对就业和犯罪的影响,同时控制药物使用严重程度、既往治疗史及其他患者人口统计学特征。数据来自国家治疗改进评估研究,包括美国各地986名参加门诊戒毒项目的成年人。我们发现,治疗完成情况和治疗时长与治疗后的就业情况显著相关。在治疗时长不变的情况下,完成计划治疗的患者随访时就业的发生率几乎是未完成治疗患者的2倍。然而,治疗完成情况对治疗后犯罪概率没有统计学上的显著影响。尽管我们的结果喜忧参半,但这些发现表明,在治疗结果研究中,应更加重视评估治疗时长和治疗完成情况的重要性。