 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Elizabeth Fournier, BS, Department of Public Policy, University of North Carolina, 250 East Franklin Street, Abernethy Hall, CB#3435, Chapel Hill, NC, NC 27599, 919-933-1841, fournier@email.unc.edu
Behavioral health can be measured along several dimensions. Different perceptions of substance abuse treatment goals result in three broad categories of outcome. While abstinence is the most common clinical measure of effectiveness, the concept of recovery includes other improvements to the consumer’s ability to fulfill responsibilities at work and at home. In addition, other stakeholders may seek to change aspects of the consumer’s behavior and lifestyle that affect public health and safety. These different aims may result in different perceptions of the effectiveness of methadone maintenance therapy and in different levels of public support. For example, abstinence advocates object to taxpayer dollars spent on a therapy that provides a dependence-producing medication for an indefinite period of time. Although multiple studies have been conducted to evaluate program- and client-level therapy differences in methadone treatment (such as dosage levels, psychotherapy services, group counseling, or peer support), little has been done to detect whether administrative differences (such as level of Medicaid reimbursement or presence of managed care) play a significant role in the feasibility and success of methadone treatment programs. Using a subset of the National Treatment Improvement Evaluation Study (NTIES), an empirical description of program-level social policy tools (such as Medicaid) will be matched to the client-level observations of methadone maintenance therapy outcomes. Multi-level modeling analysis can demonstrate whether the degree of “effectiveness” changes when outcomes are measured differently, when public support of the program varies, and can test for the interaction of these two influences on behavioral health.
Learning Objectives:
Keywords: Health Care Politics, Drug Abuse Treatment
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.