McAuliffe W E, Breer P, Ahmadifar N W, Spino C
Department of Psychiatry, Harvard Medical School, Cambridge Hospital, MA 02139.
Am J Public Health. 1991 Mar;81(3):365-71. doi: 10.2105/ajph.81.3.365.
Rhode Island's Division of Substance Abuse asked us to assess the State's drug treatment needs and make recommendations regarding its treatment system for the next three years.
We used a statewide telephone drug use survey of 5,176 households supplemented by drug-related hospital discharges, Division of Drug Control statistics, and interviews with providers, state officials, and out-of-state experts. Drug abuse was measured with items from the Diagnostic Interview Schedule. Abusers were asked if they were receiving or wanted to receive treatment.
Survey responses, used to estimate the unmet need for drug treatment, indicated a need to triple drug treatment services. Regression models using survey data indicated that the treatment network was overly centralized in the Providence area. Interviews with state officials, clinicians, and out-of-state experts provided material for recommendations on reimbursement policy, treatment mix, quality assurance, and cost containment.
The RI Department of Health's certificate-of-need program adopted our overall recommendation for tripling the drug treatment system as its guideline in evaluating proposals for new treatment facilities. With State funding of a new adolescent center and expansion of outpatient slots in the private sector, this recommendation has now been fully implemented.
罗德岛药物滥用部门要求我们评估该州的药物治疗需求,并就其未来三年的治疗系统提出建议。
我们采用了一项对5176户家庭进行的全州范围的电话药物使用调查,并辅以与药物相关的医院出院数据、药物管制部门的统计数据,以及对提供者、州官员和州外专家的访谈。药物滥用情况通过诊断访谈表中的项目进行衡量。询问滥用者是否正在接受或希望接受治疗。
用于估计药物治疗未满足需求的调查回复表明,需要将药物治疗服务增加两倍。使用调查数据的回归模型表明,治疗网络在普罗维登斯地区过度集中。对州官员、临床医生和州外专家的访谈为有关报销政策、治疗组合、质量保证和成本控制的建议提供了素材。
罗德岛卫生部的需求证明计划采纳了我们将药物治疗系统增加两倍的总体建议,作为评估新治疗设施提案的指导方针。随着州政府对一个新的青少年中心的资助以及私营部门门诊名额的增加,这一建议现已得到全面实施。