Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia.
Equity in Health and Wellbeing Program, Hunter Medical Research Institute, Newcastle, Australia.
Drug Alcohol Rev. 2023 Jul;42(5):1220-1234. doi: 10.1111/dar.13653. Epub 2023 Apr 2.
Organisational factors have been found to be associated with health outcomes in a number of health-care settings. Despite likely being an important influence on the quality of care provided within alcohol and other drug (AOD) treatment centres, the impact of organisational factors on AOD treatment outcomes have not been extensively explored. This systematic literature review examines the characteristics, methodological quality and findings of published studies exploring the association between organisational factors and client AOD treatment outcomes.
Medline, Embase, PsycINFO and the Cochrane database were searched from 2010 to March 2022 for relevant papers. Studies meeting the inclusion criteria underwent quality assessment using the Joanna Brigg's Institute critical appraisal tool for cross-sectional studies, followed by data extraction of key variables pertaining to the aims. A narrative summary was used to synthesise the data.
Nine studies met the inclusion criteria. Organisational factors examined included cultural competency, organisational readiness for change, directorial leadership, continuity of care practices, service access, service to needs ratios, dual diagnosis training, therapeutic optimism and the funding model/health-care system that treatment was delivered in. Outcome measures included duration, completion or continuation of treatment; AOD use; and patient perceptions of treatment outcomes. Seven out of nine papers found a significant interaction between at least one organisational variable and AOD treatment outcomes.
Organisational factors are likely to impact treatment outcomes for patients seeking treatment for AOD. Further examination of the organisational factors that influence AOD outcomes is needed to inform systemic improvements to AOD treatment.
在许多医疗保健环境中，组织因素已被发现与健康结果相关。尽管组织因素可能对酒精和其他药物（AOD）治疗中心提供的护理质量有重要影响，但组织因素对 AOD 治疗结果的影响尚未得到广泛探讨。本系统文献综述检查了已发表的研究中探索组织因素与客户 AOD 治疗结果之间关联的特征、方法学质量和研究结果。
从 2010 年到 2022 年 3 月，在 Medline、Embase、PsycINFO 和 Cochrane 数据库中搜索相关论文。符合纳入标准的研究使用 Joanna Brigg's Institute 横断面研究批判性评价工具进行质量评估，然后提取与目标相关的关键变量的数据。使用叙述性摘要综合数据。
符合纳入标准的研究有 9 项。检查的组织因素包括文化能力、组织变革准备、主任领导、护理连续性实践、服务获取、服务对需求比、双诊断培训、治疗乐观主义以及治疗所依据的资金模式/医疗保健系统。结果衡量标准包括治疗的持续时间、完成或继续治疗；AOD 使用；以及患者对治疗结果的看法。9 篇论文中有 7 篇发现至少有一个组织变量与 AOD 治疗结果之间存在显著相互作用。
组织因素可能会影响寻求 AOD 治疗的患者的治疗结果。需要进一步研究影响 AOD 结果的组织因素，以告知 AOD 治疗的系统性改进。
