Alexander Jeffrey A, Wells Rebecca, Jiang Lan, Pollack Harold
Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
Health Serv Manage Res. 2008 Aug;21(3):168-77. doi: 10.1258/hsmr.2007.007028.
Substance abuse treatment programmes depend on boundary spanning to identify opportunities and threats, and represent their interests to stakeholders such as licensing entities and regulators. This study sought to identify director, client, unit and market factors associated with active director boundary spanning.
Using data from the 1995, 1999-2000 and 2005 waves of a national survey of outpatient substance abuse treatment units, generalized estimating equation regression models tested associations between predictors and five aspects of directors' self-reported boundary spanning.
Directors licensed as substance abuse treatment counsellors spent more time than average consulting with other treatment providers and making presentations in the community. Older directors spent less time consulting with other treatment providers, making community presentations and liaisoning with monitoring organizations. The few associations between client unemployment and director boundary spanning were positive; the two associations between the percentage of clients who were African-American and boundary spanning were negative. Private ownership and being based in larger organizations were negatively associated with some types of boundary spanning. Perceived competition for public support was positively associated with all measures of boundary spanning.
Directors of treatment organizations may improve treatment practices and political leverage by directly, but selectively, interacting with key external stakeholders.
药物滥用治疗项目依赖跨界合作来识别机遇与威胁，并向诸如许可机构和监管机构等利益相关者代表自身利益。本研究旨在确定与活跃的项目主管跨界合作相关的主管、客户、机构和市场因素。
利用1995年、1999 - 2000年以及2005年全国门诊药物滥用治疗机构调查的数据，广义估计方程回归模型检验了预测因素与主管自我报告的跨界合作五个方面之间的关联。
拥有药物滥用治疗顾问执照的主管比平均水平花费更多时间与其他治疗提供者协商，并在社区进行展示。年长的主管花费较少时间与其他治疗提供者协商、在社区进行展示以及与监测组织联络。客户失业率与主管跨界合作之间的少数关联为正向；非裔美国客户所占百分比与跨界合作之间的两个关联为负向。私有制以及隶属于较大型组织与某些类型的跨界合作呈负相关。感知到的对公共支持的竞争与所有跨界合作指标均呈正相关。
治疗机构的主管可以通过直接但有选择地与关键外部利益相关者互动来改善治疗实践和政治影响力。
