Guerrero Erick G, Harris Lesley, Padwa Howard, Vega William A, Palinkas Lawrence
USC School of Social Work, University of Southern California, 1150 South Olive Street, Los Angeles, CA, 90015, USA.
Kent School of Social Work, University of Louisville, Louisville, KY, 40292, USA.
Adm Policy Ment Health. 2017 Jul;44(4):463-469. doi: 10.1007/s10488-015-0662-9.
Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.
关于《平价医疗法案》（ACA）将如何在公共资助的成瘾健康服务（AHS）机构中实施，目前所知甚少。本研究以医疗保健系统中新实践实施的概念模型为指导，依赖于2013年从加利福尼亚州洛杉矶县的30名AHS临床主管那里收集的定性数据。访谈内容被转录、编码，并使用带有ATLAS.ti软件的建构主义扎根理论方法进行分析。主管们预计ACA实施会产生若干潜在影响，包括AHS服务使用的增加、AHS服务时长和强度的变化，以及劳动力专业化。然而，主管们并未准备好采取行动，使他们项目的战略变革计划与政策期望保持一致。研究结果表明，需要进行医疗保健政策干预，以帮助治疗提供者有效应对ACA中改善护理标准和减少差异的原则。
