title: Practice variation and length of stay in alcohol and drug detoxification centers.
abstract: Admissions to 20 publicly funded alcohol and drug detoxification centers in Massachusetts were examined to identify program and patient variables that influenced length of stay. The last admission during fiscal year 1996 was abstracted for patients 18 years of age and older seeking alcohol, cocaine, or heroin detoxification (n=21,311; 29% women). A hierarchical generalized linear model examined the effects of patient and program characteristics on variation in length of stay and tested case-mix adjustments. Program size had the most influence on mean adjusted length of stay; stays were more than 40% longer in detoxification centers with 35 or more beds (7.69 days) than in centers with less than 35 beds (5.42 days). The study highlights the contribution of program size to treatment processes and suggests the need for more attention to program attributes in studies of patient outcomes and treatment processes.
authors.affiliation: Department of Mathematics and Statistics, Mississippi State University, Mississippi State, MS 39762, USA.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Jonkman
authors.forename: Dennis
authors.initials: D
authors.lastname: McCarty
authors.forename: Henrick J
authors.initials: HJ
authors.lastname: Harwood
authors.forename: Sharon-Lise
authors.initials: SL
authors.lastname: Normand
authors.forename: Yael
authors.initials: Y
authors.lastname: Caspi
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D019970:Cocaine-Related Disorders / Q000534:rehabilitation*; D003953:Diagnosis-Related Groups; D005260:Female; D006276:Health Facility Size; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D016320:Substance Abuse Treatment Centers / Q000592:standards / Q000706:statistics & numerical data*