Gender differences in predictors of initiation, retention, and completion in an HMO-based substance abuse treatment program.
We studied gender differences in treatment process indicators among 293 HMO members recommended for substance abuse treatment. Treatment initiation, completion, and time spent in treatment did not differ by gender, but factors predicting these outcomes differed markedly. Initiation was predicted in women by alcohol diagnoses; in men, by being employed or married. Failure to initiate treatment was predicted in women by mental health diagnoses; in men, by less education. Treatment completion was predicted in women by higher income and legal/agency referral; in men, by older age. Failure to complete was predicted in women by more dependence diagnoses and higher Addiction Severity Index Employment scores; in men, by worse psychiatric status, receiving Medicaid, and motivation for entering treatment. More time spent in treatment was predicted, in women, by alcohol or opiate diagnoses and legal/agency referral; in men, by fewer mental health diagnoses, higher education, domestic violence victim status, and prior 12-step attendance. Clinical implications of results are discussed.
Green
Carla A
CA
Oregon Health & Science University, Department of Public Health & Preventive Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97201-3098, USA. carla.a.green@kpchr.org
Polen
Michael R
MR
Dickinson
Daniel M
DM
Lynch
Frances L
FL
Bennett
Marjorie D
MD
D000328:Adult; D005260:Female; D005783:Gender Identity; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012153:Retention, Psychology; D012737:Sex Factors; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D014481:United States