Friedmann Peter D, Hendrickson James C, Gerstein Dean R, Zhang Zhiwei
Brown Medical School, Division of General Internal Medicine, Department of Medicine, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903, USA.
J Behav Health Serv Res. 2004 Jan-Mar;31(1):86-97. doi: 10.1007/BF02287341.
This study examines whether having designated case management staff facilitates delivery of comprehensive medical and psychosocial services in substance abuse treatment programs. A multilevel, prospective cohort study of 2829 clients admitted to selected substance abuse treatment programs was used to study clients from long-term residential, outpatient, and methadone treatment modalities. Program directors reported whether the program had staff designated as case managers. After treatment discharge, clients reported their receipt of 9 supplemental services during the treatment episode. In multivariate models controlling for multiple program-level and client-level factors, program-level availability of designated case managers increased client-level receipt of only 2 of 9 services, and exerted no effect on service comprehensiveness, compared to programs that did not have designated case managers. These findings do not support the common practice of designating case management staff as a means to facilitate comprehensive services delivery in addiction treatment programs.
本研究探讨指定个案管理工作人员是否有助于在药物滥用治疗项目中提供全面的医疗和心理社会服务。一项对2829名入住选定药物滥用治疗项目的客户进行的多层次前瞻性队列研究，用于研究来自长期住院、门诊和美沙酮治疗模式的客户。项目主任报告该项目是否有被指定为个案经理的工作人员。治疗出院后，客户报告了他们在治疗期间接受的9项补充服务。在控制了多个项目层面和客户层面因素的多变量模型中，与没有指定个案经理的项目相比，项目层面指定个案经理的可获得性仅增加了客户层面9项服务中的2项的接受率，并且对服务的全面性没有影响。这些发现不支持将指定个案管理工作人员作为促进成瘾治疗项目中全面服务提供的一种手段的普遍做法。
