Lemak Christy Harris, Alexander Jeffrey A
Department of Health Services Research, Management and Policy of the University of Florida, P.O. Box 100195, Gainesville, Florida 32610-0195, USA.
Psychiatr Serv. 2005 Aug;56(8):934-9. doi: 10.1176/appi.ps.56.8.934.
This study examined whether and how various organizational and environmental forces influence staffing in outpatient substance abuse treatment programs.
The authors used data from the 1995 and 2000 waves of the National Drug Abuse Treatment System Survey (NDATSS), a telephone survey of unit directors and clinical supervisors. Multivariate analyses with generalized estimating equations were conducted. Two measures of staffing were modeled: the number of weekly treatment hours per client, and active caseload.
Managed care activity influenced active caseloads but not the number of treatment hours per client. Significant differences were noted in staffing levels among private for-profit, private nonprofit, and public treatment programs, with public units offering fewer hours per client and having larger caseloads. Units accredited by the Joint Commission on Accreditation of Healthcare Organizations offered more treatment hours per client.
The results of this study contribute to the understanding of various influences on treatment staff time and caseloads. Understanding these relationships is critical for policy makers, managed care companies, and managers, because staffing levels have the potential to affect both the cost and the quality of treatment.
本研究探讨了各种组织和环境因素是否以及如何影响门诊药物滥用治疗项目的人员配备。
作者使用了1995年和2000年全国药物滥用治疗系统调查(NDATSS)的数据,该调查通过电话对单位主任和临床主管进行。采用广义估计方程进行多变量分析。对两种人员配备指标进行了建模:每位客户每周的治疗小时数和活跃病例数。
管理式医疗活动影响活跃病例数,但不影响每位客户的治疗小时数。营利性私立、非营利性私立和公共治疗项目的人员配备水平存在显著差异,公共单位每位客户提供的治疗小时数较少,病例数较多。获得医疗组织认证联合委员会认证的单位每位客户提供的治疗小时数更多。
本研究结果有助于理解对治疗人员时间和病例数的各种影响。理解这些关系对政策制定者、管理式医疗公司和管理人员至关重要,因为人员配备水平有可能影响治疗的成本和质量。