Gender Differences in Access to Publicly-Funded Substance Abuse Services

获得公共资助的药物滥用服务方面的性别差异

• 批准号: 8198382
• 负责人: Christina Marie Andrews
• 金额: $ 2.43万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8198382
• 关键词: Address; Admission activity; Affect; Alcohol or Other Drugs use; Alcoholism; Authorization documentation; Case Management; Characteristics; Client; Criminal Justice; Data; Data Set; Development; Disease; Dropout; Economics; Empirical Research; Exhibits; Face; Funding; Gender; Geographic Distribution; Glean; Health Care Costs; Illinois; Individual; Intervention; Knowledge; Measures; Movement; Policies; Population; Populations at Risk; Proportional Hazards Models; Public Health; Records; Reporting; Research; Resources; Sampling; Secure; Services; Sex Characteristics; Societies; Substance Addiction; Substance Use Disorder; Substance abuse problem; System; Time; United States; Woman; addiction; experience; hazard; help-seeking behavior; improved; men; programs; public health relevance; rural area; social; statistics; substance abuse treatment; therapy design; therapy development; treatment program

DESCRIPTION (provided by applicant): Few individuals in need of substance abuse services actually receive them. Estimates suggest that in the United States, only 10% of individuals with substance abuse disorders ever obtain services for their condition. Among the most commonly cited barriers to access among seekers of substance abuse services is wait time. Empirical studies corroborate this claim, suggesting that waiting more than a single day decreases the likelihood that an individual seeking services will show up when they become available. Despite the critical importance of wait time as a component of access, no studies have attempted to document-at least not at the state or national level-how long individuals typically wait to receive substance abuse services in the publicly- funded system. Additionally, it is unknown whether there are gender differences in wait time. While at least three studies suggest that women may wait longer than men to receive substance abuse services after initial request, these studies suffer from significant methodological weaknesses, including limited generalizability, non-representative sampling, and the absence of measures to address censoring. Similarly, little is known about the factors that drive wait time to receive services. To address this gap, this study will identify components of substance abuse service policy, financing and programs that are associated with shorter wait time to treatment entry for men and women. Additionally, it will identify client populations that are most likely to experience long wait times to enter treatment and thus may be particularly vulnerable to pre-treatment dropout. Such knowledge can be used to inform the development of targeted interventions at the levels of policy and practice to reduce wait times. To this end, the study will develop multilevel proportional hazard models to pursue the following specific aims: (1) to examine how the likelihood of assessment changes as a function of wait time by gender; (2) to identify client and program factors associated with wait time to assessment by gender; (3) to examine how the likelihood of treatment entry changes as a function of wait time by gender; and (4) to identify client and program factors associated with wait time to treatment entry by gender. To conduct the study, data from the Illinois Division of Alcoholism and Substance Abuse (DASA) will be used. The study will include roughly 200,000 treatment records from 2006- 2008 from the DASA Automated Reporting and Tracking System (DARTS). DARTS includes unique client identifiers that allow for tracking clients' movements throughout the system. While this dataset is not publicly available, permission to use it has already been secured. PUBLIC HEALTH RELEVANCE: Despite the significant economic, social, and public health costs of substance abuse, as few as 10% of individuals with substance use disorders ever receive services for their condition. Among the most commonly-cited reasons for not entering treatment is wait time to receive services. The proposed study will identify specific factors at the levels of policy and practice that can be reworked to decrease wait times and consequently improve rates of substance abuse treatment access in the public system.

描述（由申请人提供）：很少有人需要滥用药物服务。估计表明，在美国，只有10％的患有药物滥用障碍的人为其病情获得服务。在寻求药物滥用服务的寻求者中，最常见的障碍是等待时间。经验研究证实了这一主张，表明等待一天以上的时间降低了个人寻求服务在可用时出现的可能性。尽管等待时间是访问的一部分至关重要的重要性，但没有任何研究试图记录文档 - 至少没有在州或国家级别上，很长的人通常会等待在公共资助的系统中接受药物滥用服务。此外，尚不清楚等待时间是否存在性别差异。虽然至少三项研究表明，在初步要求之后，女性可能会等待比男性更长的时间接受药物滥用服务，但这些研究遭受了严重的方法论弱点，包括有限的可推广性，非代表性的采样以及缺乏解决审查措施的措施。同样，对于推动等待时间接收服务的因素知之甚少。为了解决这一差距，这项研究将确定与较短的等待时间治疗男女治疗有关的滥用药物服务政策，融资和计划的组成部分。此外，它将确定最有可能经历长时间等待时间进入治疗的客户群体，因此可能特别容易受到治疗前辍学的影响。这些知识可用于告知在减少等待时间的政策和实践水平上的有针对性干预措施的发展。为此，该研究将开发多级比例危害模型，以追求以下特定目的：（1）检查评估的可能性如何随性别等待时间而变化； （2）确定与等待时间相关的客户和计划因素； （3）检查治疗的可能性如何随性别等待时间而变化； （4）确定与等待时间进行性别治疗有关的客户和程序因素。为了进行研究，将使用伊利诺伊州酒精中毒和滥用药物（DASA）的数据。该研究将包括2006年至2008年的大约200,000个治疗记录，来自DASA自动报告和跟踪系统（DARTS）。飞镖包括唯一的客户端标识符，允许跟踪整个系统中客户的动作。尽管该数据集未公开可用，但使用该数据集已被确保使用。 公共卫生相关性：尽管滥用药物的经济，社会和公共卫生成本巨大，但只有10％的患有药物使用障碍的人曾经为其病情提供服务。不加入治疗的最常见原因之一是等待服务的时间。拟议的研究将在政策和实践水平上确定可以重新设计的特定因素，以减少等待时间，从而提高公共系统中药物滥用治疗的访问率。