A national comparison of public- and private-sector alcoholism treatment delivery system characteristics.

2007

J Health Soc Behav

Many studies of innovation adoption in health care organizations focus either on organizational characteristics or the institutional environment, but not both. Furthermore, these perspectives are rarely employed simultaneously in both public and private health care organizations. This research considers the public-private distinction, organizational compatibility, and interorganizational referral relationships in the use of selective serotonin reuptake inhibitors (SSRIs) by substance abuse treatment organizations. Using data from nationally representative samples of 363 publicly funded and 403 privately funded substance abuse treatment centers, a four-category typology of public and private organizations initially predicted variation in SSRI use. However some differences were no longer significant once organizational and environmental characteristics were added to the statistical model. These data support hypotheses about the associations between organizational characteristics and SSRI use as well as hypotheses regarding the external environment. Future research should continue to integrate both internal and external factors in theoretical explanations of innovation adoption.

Section: Theory Evidence and Hypotheses Public And Private Organizamentioning

confidence: 99%

Section: Theory Evidence and Hypotheses Public And Private Organizamentioning

confidence: 99%

The Use of Antidepressant Medications in Substance Abuse Treatment: The Public-Private Distinction, Organizational Compatibility, and the Environment

Knudsen

Ducharme²,

2007

J Health Soc Behav

“…There has long been concern regarding disparities in the quality of services provided in public vs. private treatment centers (Knudsen, et al, 2006; Rodgers & Barnett, 2000; Yahr, 1986). However, studies that have examined differences between public and private centers in EBP adoption have typically operationalized this variable in terms of funding source, i.e.centers with the majority of funding from public sources defined as public centers (i.e., Knudsen, et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Organizational factors associated with the use of contingency management in publicly funded substance abuse treatment centers

Bride

Abraham

Journal of Substance Abuse Treatment

2011

A promising area within technology transfer studies is the identification of organizational factors that influence the adoption of treatment innovations. While studies have identified organizational factors associated with the adoption of pharmacological innovations, few studies have examined organizational factors in the adoption of psychosocial innovations, among which contingency management (CM) is a significant practice. Using data from a sample (n = 318) drawn from the population of publicly funded treatment centers in the U.S., this study modeled organizational factors falling in the domains of structural characteristics, workforce variables, values and norms, and patient characteristics associated with the use of CM. Organizations were more likely to use CM if they: embrace a supportive therapeutic approach, are research-friendly, offer only outpatient levels of care, or serve drug-court patients. Implications for studying the diffusion and implementation of evidence-based psychosocial interventions are discussed.

“…These different types of organizations are subject to different environmental contingencies (Perry and Rainey, 1988;Walmsley and Zald, 1973), which may result in differences in patterns of service delivery. Furthermore, there has been a longstanding concern that disparities in access to high-quality services may exist for clients served by the public treatment system (Rodgers and Barnett, 2000;Yahr, 1986).…”

Section: Introductionmentioning

confidence: 99%

The adoption of medications in substance abuse treatment: Associations with organizational characteristics and technology clusters

Knudsen

Ducharme

Drug and Alcohol Dependence

2007

124

Despite growing interest in closing the "research to practice gap," there are few data on the availability of medications in American substance abuse treatment settings. Recent research suggests that organizational characteristics may be associated with medication availability. It is unclear if the availability of medications can be conceptualized in terms of "technology clusters," where the availability of a medication is positively associated with the likelihood that other medications are also offered. Using data from 403 privately funded and 363 publicly funded specialty substance abuse treatment centers in the US, this research models the availability of agonist medications, naltrexone, disulfiram, and SSRIs. Bivariate logistic regression models indicated considerable variation in adoption across publicly funded non-profit, government-owned, privately funded non-profit, and forprofit treatment centers. Some of these differences were attenuated by organizational characteristics, such as accreditation, the presence of staff physicians, and the availability of detoxification services. There was some evidence that naltrexone, disulfiram, and SSRIs represent a group of less intensely regulated medications that is distinct from more intensely regulated medications. These types of medications were associated with somewhat different correlates. Future research should continue to investigate the similarities and differences in the predictors of medication availability across national contexts.