title: Managed care and technical efficiency in outpatient substance abuse treatment units.
abstract: This article examines (1) the extent to which managed care participation is associated with technical efficiency in outpatient substance abuse treatment (OSAT) organizations and (2) the contributions of specific managed care practices as well as other organizational, financial, and environmental attributes to technical efficiency in these organizations. Data are from a nationally representative sample survey of OSAT organizations conducted in 1995. Technical efficiency is modeled using data envelopment analysis. Overall, there were few significant associations between managed care dimensions and technical efficiency in outpatient treatment organizations. Only one managed care oversight procedure, the imposition of sanctions by managed care firms, was significantly associated with relative efficiency of these provider organizations. However, several organizational factors were associated with the relative level of efficiency including hospital affiliation, mental health center affiliation, JCAHO accreditation, receipt of lump sum revenues, methadone treatment modality, percentage clients unemployed, and percentage clients who abuse multiple drugs.
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. jalexand@umich.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Alexander
authors.forename: J R
authors.initials: JR
authors.lastname: Wheeler
authors.forename: T A
authors.initials: TA
authors.lastname: Nahra
authors.forename: C H
authors.initials: CH
authors.lastname: Lemak
mesh_terms: D000553:Ambulatory Care / Q000592:standards; D016009:Chi-Square Distribution; D017598:Efficiency, Organizational / Q000592:standards*; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D016013:Likelihood Functions; D008329:Managed Care Programs / Q000592:standards*; D008605:Mental Health Services / Q000592:standards; D018803:Models, Economic; D016320:Substance Abuse Treatment Centers / Q000145:classification / Q000592:standards*; D019966:Substance-Related Disorders / Q000628:therapy*; D014481:United States