title: Designated case managers as facilitators of medical and psychosocial service delivery in addiction treatment programs.
abstract: This study examines whether having designated case management staff facilitates delivery of comprehensive medical and psychosocial services in substance abuse treatment programs. A multilevel, prospective cohort study of 2829 clients admitted to selected substance abuse treatment programs was used to study clients from long-term residential, outpatient, and methadone treatment modalities. Program directors reported whether the program had staff designated as case managers. After treatment discharge, clients reported their receipt of 9 supplemental services during the treatment episode. In multivariate models controlling for multiple program-level and client-level factors, program-level availability of designated case managers increased client-level receipt of only 2 of 9 services, and exerted no effect on service comprehensiveness, compared to programs that did not have designated case managers. These findings do not support the common practice of designating case management staff as a means to facilitate comprehensive services delivery in addiction treatment programs.
authors.affiliation: Brown Medical School, Division of General Internal Medicine, Department of Medicine, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903, USA. pfriedmann@lifespan.org
authors.forename: Peter D
authors.initials: PD
authors.lastname: Friedmann
authors.forename: James C
authors.initials: JC
authors.lastname: Hendrickson
authors.forename: Dean R
authors.initials: DR
authors.lastname: Gerstein
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D019090:Case Management / Q000706:statistics & numerical data*; D003191:Comprehensive Health Care / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008691:Methadone / Q000627:therapeutic use; D011446:Prospective Studies; D012044:Regression Analysis; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000208:ethnology / Q000534:rehabilitation*; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone