Schneider Institutes for Health Policy, Heller School, MS 035, Brandeis University, Waltham, MA 02454-9110, USA.
J Subst Abuse Treat. 2012 Jun;42(4):339-45. doi: 10.1016/j.jsat.2011.09.012. Epub 2011 Nov 23.
We examined on-site and off-site referral-based provision of substance abuse (SA) treatment services among a sample of community health centers (CHCs). Analyses used survey data collected from CHCs in three states merged with administrative claims to both characterize CHC care delivery models and examine the association between models and care quality. Care quality was based on the Washington Circle measures of initiation and engagement. Approximately half the sample provided at least some SA treatment services on site. The provision of intensive outpatient treatment services on site was associated with significantly higher engagement rates. It was also associated with higher (but not significantly) initiation rates. At the same time, on-site provision of screening and counseling services was negatively associated with both initiation and engagement rates. Given limited resources, investing in more intensive services on site may yield better outcomes for CHC patients than lower level services, but further study is recommended.
我们研究了在社区卫生中心（CHC）中基于现场和场外转介的物质滥用（SA）治疗服务提供情况。分析使用了从三个州的 CHC 收集的调查数据，并与行政索赔数据合并，以描述 CHC 的护理提供模式，并研究模型与护理质量之间的关联。护理质量基于华盛顿圈的启动和参与措施。大约一半的样本在现场至少提供了一些 SA 治疗服务。现场提供强化门诊治疗服务与显著更高的参与率相关。它也与更高（但不显著）的启动率相关。同时，现场提供筛查和咨询服务与启动和参与率均呈负相关。鉴于资源有限，在现场投资更多的强化服务可能会为 CHC 患者带来比低级别服务更好的结果，但建议进一步研究。
