Campbell Cynthia I, Alexander Jeffrey A
Department of Psychiatry, University of California, San Francisco, CA, USA.
J Behav Health Serv Res. 2006 Jan;33(1):1-19. doi: 10.1007/s11414-005-9002-2.
Women entering substance abuse treatment have more severe substance abuse problems and more medical and psychiatric comorbidities than men. Research shows that specialized women's services are associated with better retention and outcomes but relatively little is known about their availability nationwide. This study examined the adoption and implementation of reproductive and female-sensitive social services in a national sample of outpatient substance abuse treatment (OSAT) organizations in 1995 (N = 617) and 2000 (N = 571) by several organizational factors. Overall, reproductive and social services for women have not been widely adopted, although some services did increase over the study period, particularly social services. There was no evidence of large-scale decreases in service availability over the study period, although child care did decline. Nonprofit and public ownership (relative to for-profit) were associated with greater service provision. Managed care units had greater service adoption compared to nonmanaged care units, and this increased over time. Public units and hospital-affiliated units had greater service implementation than other units. However, OSAT units did not always implement the services they adopted, suggesting access to some services may be restricted.
进入药物滥用治疗机构的女性比男性存在更严重的药物滥用问题，同时患有更多的医学和精神疾病共病。研究表明，专门针对女性的服务与更高的留存率和更好的治疗效果相关，但全国范围内此类服务的可及性情况却鲜为人知。本研究通过若干组织因素，考察了1995年（N = 617）和2000年（N = 571）全国门诊药物滥用治疗（OSAT）机构样本中生殖及对女性敏感的社会服务的采用和实施情况。总体而言，针对女性的生殖和社会服务尚未得到广泛采用，不过在研究期间，一些服务有所增加，尤其是社会服务。尽管儿童保育服务确实有所减少，但在研究期间并无证据表明服务可及性出现大规模下降。非营利性和公有制（相对于营利性）与更多的服务提供相关。与非管理式护理单位相比，管理式护理单位对服务的采用率更高，且这一比例随时间推移有所增加。公立单位和医院附属单位的服务实施情况优于其他单位。然而，OSAT单位并非总能实施其采用的服务，这表明某些服务的可及性可能受到限制。
