Wells Rebecca, Lemak Christy H, Alexander Jeffrey A, Nahra Tammie A, Ye Yining, Campbell Cynthia I
Health Policy and Administration, University of North Carolina, 1104 F McGavran-Greenberg Hall, Chapel Hill, NC 27599-7411, USA.
J Subst Abuse Treat. 2007 Jul;33(1):43-50. doi: 10.1016/j.jsat.2006.11.010. Epub 2007 Jan 16.
Licensing and accreditation are widely used to improve and convey organizational quality. The objective of this study was to provide substance abuse treatment stakeholders with better evidence about how well licensing and accreditation actually correlate with staffing and treatment practices. Regressions using data from national surveys of outpatient substance abuse treatment facilities indicated that no form of licensing or accreditation was associated with better staff-to-client ratios or with one important aspect of comprehensive treatment -- the percentage of clients receiving routine medical care. There were several positive associations between licensing/accreditation and other aspects of treatment comprehensiveness. Three categories of licensure/accreditation were also positively associated with use of after-treatment plans. Post hoc analyses revealed that accreditation was associated with units' organizational contexts and referral sources as well as the nature of the competitive environment. Licensing/accreditation may reveal as much about units' institutional environments as about the quality of treatment provided.
许可和认证被广泛用于提高和传达组织质量。本研究的目的是为药物滥用治疗的利益相关者提供更好的证据，以说明许可和认证实际上与人员配备及治疗实践的关联程度。使用来自门诊药物滥用治疗机构全国调查数据的回归分析表明，任何形式的许可或认证都与更好的员工与客户比例或综合治疗的一个重要方面——接受常规医疗护理的客户百分比无关。许可/认证与治疗全面性的其他方面存在若干积极关联。三类许可/认证也与使用治疗后计划呈正相关。事后分析表明，认证与单位的组织背景、转诊来源以及竞争环境的性质有关。许可/认证可能更多地揭示了单位的机构环境，而非所提供治疗的质量。
