Table of Contents (TOC)

Cover

List of Figures

List of Tables

Highlights

1. Health Services Utilization by Individuals with Substance Use and Mental Disorders (Carol L. Council and Jeremy W. Bray)
Health Services Research
Health Services Research in the Behavioral Health Sciences
     DARP, TOPS, and DATOS
     CODAP and TEDS
     DSRS, SROS, and ADSS
     NTIES
     NCS
Overview of Chapters and Key Issues
     Access, Financing, and Costs
     Treatment Retention
     Data Limitations
     Treatment Choice
References

2. Access to Substance Abuse Treatment and Mental Health Services: A Literature Review (Albert Woodward)
Introduction
Methods
Definitions of Treatment Access
Determinants of Mental Health Services Access
     Severity of Illness
     Demographics
     Delivery System
     Financing
Determinants of Substance Abuse Treatment Access
     Need and Demographics
     Seeking Treatment
     Financial Barriers
Discussion
References

3. Substance Use and Mental Disorder Discharges from U.S. Community Hospitals in the Early 1990s, Revisited (Sarah Q. Duffy)
Introduction
Data
Methods
     Study Sample
     Statistical Methods
Results
Discussion
References

4. Do Client Characteristics Affect Admission to Inpatient Versus Outpatient Alcohol Treatment in Publicly Monitored Programs? (Sarah Q. Duffy, Gary A. Zarkin, and Laura J. Dunlap)
Introduction
Background
Data
Empirical Framework
     Baseline Model
     Expected Payer Model
Results
     Baseline Models
     Expected Payer Model
Discussion
References

5. Client Choice among Standard Outpatient, Intensive Outpatient, Residential, and Inpatient Alcohol Treatment in State-Monitored Programs (Sarah Q. Duffy, Laura J. Dunlap, and Gary Zarkin)
Introduction
Treatment Settings
Data
Empirical Framework
     Substance Use Disorder Severity
     Socioeconomic and Demographic Characteristics
Specification Tests
Results
     Descriptive Statistics
     Specification Tests
     Multivariate Results
Discussion
References

6. Length of Stay among Female Clients in Substance Abuse Treatment (Olivia Silber Ashley, Lev Sverdlov, and Thomas M. Brady)
Introduction
Empirical Model
     Predisposing Characteristics: Age, Race, and Education
     Enabling Characteristics: Referral Source and Payment Source
     Organizational Characteristics: Substance Abuse Treatment Programming for Women
Methods
     Sample
     Measures
     Analytic Approach
Results
     Retention, by Predisposing Characteristics
     Retention, by Enabling Characteristics
     Retention, by Organizational Characteristics
     Multivariate Analysis
Discussion
References

7. A Hybrid Cost Function for Outpatient Nonmethadone Substance Abuse Treatment Facilities (Sarah Q. Duffy, Laura J. Dunlap, Moshe Feder, and Gary A. Zarkin)
Introduction
Cost Function Specification
Data
     Case Mix Adjustment for Substance Abuse Treatment Facilities
     Facility Characteristics
Estimation
Results
     Cost Function Results
Discussion
References

8. Effects of Reporting Requirements on Estimates from the Treatment Episode Data Set (TEDS) (Sarah Q. Duffy)
Introduction
Substance Abuse Treatment: A Two-Tiered System
Selection Bias in Studies of Substance Abuse Treatment Facilities
Bivariate Probit Model
Estimation Strategy
Data and Model Specifications
     Seemingly Unrelated Probit Specification
     Bivariate Probit
Results
     Descriptive Statistics
     Multivariate Analyses
     Bivariate Probit Results Compared with Univariate Probit Results
     Policy Simulations
Discussion
References

9. Conclusions and Implications (Carol L. Council and Jeremy W. Bray)
Introduction
Access, Financing, and Costs of Substance Abuse Treatment and Mental Health Services
     Implications for Access for High-Risk Populations
     Implications for Service Delivery
     Implications for Treatment Outcomes
     Implications for Public- and Private-Sector Care
Community Hospitalizations of Those with Substance Use and/or Mental Disorders
     Implications for the Public Sector
     Implications for Community Hospitals and Providers
Treatment Retention
     Implications for Treatment of Specific Populations
Treatment Choice
     Implications for States
     Implications for Characterization of Treatment Options
Data Issues in Behavioral Health Care Research
     Implications for Federal and State Data Systems
Conclusions
References

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