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1993-2003 Treatment Episode Data Set (TEDS) Report of Substance Abuse Treatment Admissions |
Chapter 4
State Data: 1993-2003
TEDS aggregates data collected through the data collection systems of the Single State Agencies (SSAs) for substance abuse treatment. States have cooperated with the Federal government in the data collection process, and substantial progress has been made toward developing a standardized data set. However, because each State system is unique and each State has unique powers and mandates, significant differences exist among State data collection systems. These differences are compounded by evolving health care payment systems.
State-to-State comparisons must be made with extreme caution. Table 4.1 presents key characteristics of State data collection systems for 2003. However, these characteristics can change as State substance abuse treatment systems change, and thus may be responsible for some year-to-year variation within States. Sources of apparent variation in State-to-State substance abuse patterns include:
Completeness of reporting. Completeness of reporting
at the cutoff date for preparation of this report varied from State to State.
Future submissions of 2003 data are unlikely to affect the percentage distributions
that are the basis of this report but may affect State-level counts and
rates of admission. In addition, States review and improve their data collection
and processing. Occasionally, States send revised data for earlier years
to TEDS.
Figure 27a, Figure
27b, Figure 27c, Figure
27d, Figure 27e, and Figure
27f show for individual States and jurisdictions the number of admissions
reported by month. States are grouped according to the average number of
admissions reported per month.
Facilities included. Most States require facilities
that receive State/public funding to report data to the State. "State/public
funding" generally refers to funding distributed by the SSA, but may
also include funding distributed through another public agency. Some States
require that additional categories (e.g., private facilities, methadone
clinics, etc.) also report. In some States, other categories of facilities
report voluntarily. See Table 4.1
for additional details.
Clients included. About half the States report data
on all clients in a facility that is required to report to the State. However,
some States report only those clients whose treatment is paid for with State/public
funds. See Table 4.1 for additional
details.
Admissions and transfers. Great variation is seen
in the States’ ability to identify and report client admissions and transfers.
The goal for the TEDS system is to identify treatment episodes. Thus a change
in service type or a change in provider, without an interruption in treatment,
would ideally be categorized as a transfer. This requires, however, that
clients be assigned unique IDs that can be linked across providers; not
all States are legally and/or technologically able to do this. About half
of all States can identify transfers that occur when a client changes service
type within the structure of a given provider. However, far fewer can identify
a transfer that occurs when a client changes providers. Several States do
not track transfers, but instead report as transfers those clients who are
discharged and readmitted within a specified time period (which may vary
from State to State). See Table 4.1
for additional details. Annual counts of admissions, transfers, and codependents
are shown in Table 4.2a, Table
4.2b, and Table 4.2c.
Data items. Not all States report all data items
in the Minimum and Supplemental Data Sets. Most States report the Minimum
Data Set for all or nearly all TEDS admissions. However, the items reported
from the Supplemental Data Set vary across States.
Table 4.3 and Table
4.4 indicate, by State, the item response rates for the Minimum and
Supplemental Data Sets.
Treatment resources available. States differ widely
in the amount of public funding available for substance abuse treatment
and in the constraints placed on the use of funds. States may be directed
to target special populations such as pregnant women or adolescents. Where
funds are limited, States may be compelled to exercise triage in admitting
persons to treatment, admitting only those with the most "severe"
problems. In States with higher funding levels, a larger proportion of the
population in need of treatment may be admitted, including the less severely
impaired.
Population subgroups. States may include or exclude
reporting by certain sectors of the treatment population, and these sectors
may change over time. For example, treatment programs based in the criminal
justice system may or may not be administered through the State SSA. Detoxification
facilities, which can generate large numbers of admissions, are not uniformly
considered treatment facilities and are not uniformly reported by all States.
As an illustration, the number of TEDS admissions reported in Texas declined
significantly between 1995 and 1996. The most significant factor in this
decline was that a substantial number of substance abuse clients treated
through the criminal justice system were no longer reported to the SSA.
In addition, a reallocation of resources resulted in the closure of several
detoxification units.
Table 4.5a presents, by State, the numbers of admissions aged 12 and over for 1993 to 2003. Table 4.5b presents, by State, admission rates per 100,000 population aged 12 and over for 1993 to 2003. Table 4.6 presents rates per 100,000 population aged 12 and over adjusted for age, sex, and race/ethnicity. Age adjustment is used to take into account demographic variation across States. It compares the distributions under the assumption that each State’s TEDS population and the U.S. population had the same age, sex, and racial/ethnic composition.
Table 4.7a presents, by State and primary substance, the numbers of admissions aged 12 and over for 2003. Table 4.7b and Table 4.8 present the crude and adjusted rates, respectively, based on these admissions.
Interpretation of these tables and comparisons across States should be made cautiously and should take into account the many sources of variation detailed above.
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 4.11.05. |
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 4.11.05. |
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 4.11.05. |
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 4.11.05. |
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 4.11.05. |
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 4.11.05. |
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