Science-based and practice-based innovativeness and performance of substance abuse treatment facilities.
BACKGROUND
The fields of mental health and substance abuse treatment lag significantly behind other health care organizational fields in the adoption, implementation, and dissemination of evidence-based practices. Innovative organizational practices may be science based or practice based. The implementation of innovative practices requires considerable organizational resources. Whether this organizational investment actually pays off in terms of superior performance is unclear. This issue in the context of substance abuse treatment facilities (SATFs) in the United States is examined in this study.


OBJECTIVE
The purpose of this study is to examine the influence of the use of innovative organizational practices, both science based (psychosocial interventions) and practice based, on the organizational performance of SATFs.


METHODS
The study uses cross-sectional data on 13,513 SATFs in the United States, obtained from the National Survey of Substance Abuse Treatment Services 2009 database.


RESULTS
Multinomial logistic regression models find a positive association between the use of science-based innovations and practice-based innovations and organizational performance, that is, the provision of comprehensive (core and wraparound) services. SATFs that were located in metropolitan areas, those accredited by the Commission on Accreditation of Rehabilitation Facilities and Joint Commission, that had a mixed (Substance Abuse and Mental Health) focus or were recipients of earmark funds also had higher organizational performance.


CONCLUSIONS
The results signify that substance abuse facilities that are high innovators in terms of implementing science based and practice-based innovative practices have higher organizational performance. Organizations that have institutionalized these practices have invested considerable resources in innovation. The shown higher organizational performance provides justification for the organizational investment in innovation.
Preethy Nayar, MD, PhD, MPhil, is Assistant Professor, Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Nebraska Medical Center, Omaha. E-mail: pnayar@unmc.edu. Fang Yu, PhD, is Assistant Professor, Department of Biostatistics, University of Nebraska Medical Center, Nebraska Medical Center, Omaha. Bettye Apenteng, BSc, is Research Associate, Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Nebraska Medical Center, Omaha.
Preethy
P
Nayar
Fang
F
Yu
Bettye
B
Apenteng
D003430:Cross-Sectional Studies; D055317:Evidence-Based Practice / Q000458:organization & administration; D006801:Humans; D009936:Organizational Innovation; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration* / Q000592:standards; D019966:Substance-Related Disorders / Q000628:therapy; D014481:United States