Impact of the Philadelphia recovery model on admission to inpatient substance abuse treatment

Abstract Healthy People 2020 reported that 22 million Americans have substance abuse problems. Managed care programs have been established to reduce the cost of publicly funded treatment programs. Managed care is controversial because clinical guidelines that are applied to people with substance abuse problems may curtail patient access to needed services. Admissions to substance abuse treatment (i.e., persons beginning outpatient or inpatient substance abuse treatment in any publicly funded treatment facility) were obtained from the Substance Abuse and Mental Health data archive for 2004 and 2007. Andersen's behavioral model of health services use is the theoretical framework for this study. The purpose of this study was to examine if a managed change in the approach to substance abuse treatment had any effect on the assignments of people to inpatient care. Multiple logistic regression analysis was used to test the hypothesis that the odds that an individual admitted to treatment would be assigned to inpatient care were lower in 2007, after the implementation of the managed care recovery model, than in 2004 after adjustment for covariates. The findings showed that admissions to inpatient care declined after the recovery model was implemented among men and persons younger than 35 years of age. Implications for positive social change include providing policy makers with information about the impact the recovery model has had on admissions to inpatient substance abuse treatment, expose disparities this vulnerable population encounters, and to improve access to substance abuse treatment.