D'Aunno T, Vaughn T E
Univesity of Chicago, School of Social Service Administration, IL 60637, USA.
J Subst Abuse. 1995;7(1):27-42. doi: 10.1016/0899-3289(95)90304-6.
The effectiveness of drug abuse treatment depends in part on meeting clients' medical and social needs related to drug abuse. Yet, we know little about the type and amount of medical and social services that clients receive in outpatient drug abuse treatment units. This article addresses this issue, drawing from conceptual perspectives in organizational theory and using data from a national random sample of 481 outpatient treatment units that participated in a phone survey in both 1988 and 1990. We examine the extent to which clients in these units receive: physical (medical) and mental health care; special treatment for multiple drug abuse; and employment, financial, and legal counseling. Results from a multivariate analysis of variance (MANOVA) indicate that there was a significant decrease from 1988 to 1990 in all services we examined. Regression analyses were conducted to identify organizational and client characteristics related to these decreases. Results show that changes in both client characteristics and key organizational factors (e.g., resources, staffing) are significantly related to decreases in the services clients receive. Implications for meeting the medical and social service needs of drug abuse clients are discussed.
药物滥用治疗的有效性部分取决于满足客户与药物滥用相关的医疗和社会需求。然而，我们对门诊药物滥用治疗机构中客户所接受的医疗和社会服务的类型及数量了解甚少。本文从组织理论的概念视角出发，利用1988年和1990年参与电话调查的481个门诊治疗机构的全国随机样本数据，探讨了这一问题。我们研究了这些机构中的客户在多大程度上接受以下服务：身体（医疗）和心理健康护理；多种药物滥用的特殊治疗；以及就业、财务和法律咨询。多变量方差分析（MANOVA）的结果表明，在我们所研究的所有服务方面，1988年至1990年期间均有显著下降。我们进行了回归分析，以确定与这些下降相关的组织和客户特征。结果显示，客户特征和关键组织因素（如资源、人员配备）的变化都与客户所接受服务的减少显著相关。文中还讨论了满足药物滥用客户医疗和社会服务需求的相关启示。
