Yale University

Organizational- and individual-level correlates of posttreatment substance use: a multilevel analysis.

TitleOrganizational- and individual-level correlates of posttreatment substance use: a multilevel analysis.
Publication TypeJournal Article
Year of Publication2008
AuthorsGhose, Toorjo
JournalJournal of substance abuse treatment
Date Published2008 Mar
KeywordsAccreditation, Adult, Female, Humans, Joint Commission on Accreditation of Healthcare Organizations, Male, Managed Care Programs, Models, Organizational, Risk Factors, Substance Abuse Treatment Centers, Substance-Related Disorders, Time Factors, Treatment Outcome, United States
AbstractIn addressing the need to study the effects of organizational factors on individual-level treatment outcomes, this study used hierarchical models to examine the organizational- and individual-level correlates of posttreatment substance use. Risk for posttreatment use varied significantly across organizations. Factors in the external institutional environment of facilities significantly influenced risk for use: managed care regulation increased the risk, whereas Joint Commission on the Accreditation of Healthcare Organizations accreditation decreased it (p < .01 for both). On the individual level, longer treatment episodes and treatment completion reduced the risk (p < .01 for both) after controlling for client characteristics. The benefits of length of stay in treatment were modified by elements of the external institutional environment and organizational treatment technology. The ameliorative effects of prolonged treatment were reduced by higher levels of managed care regulation, organizational monitoring, caseload size (p < .01 for all), and proportion of degreed staff (p < .05). The results highlight the influence of organizational factors on posttreatment use.
Alternate JournalJ Subst Abuse Treat

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