title: Client incentives versus contracting and staff incentives: how care continuity interventions in substance abuse treatment can improve residential to outpatient transition.
abstract: Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; n=114) was referral to a preferred outpatient program with advance appointment optional. Client incentive (CI; n=97) offered up to $100 in gift cards for intake and attendance during the first 30days of treatment. Contracting with staff incentives (CSI; n=49) consisted of meeting with an outpatient counselor prior to residential discharge, signing an attendance contract, receiving an appointment and payment to staff if clients attended. CSI significantly improved rates of successful transition (84%) and admission (74%) compared to UC (64% contact; 49% admitted). CI did not result in significantly improved outcomes (74%; 60%). CSI was likely mediated by the reliability (92 versus 52% in UC) and immediacy (1.0 versus 3.9days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment.
authors: University of Cincinnati, School of Social Work, Cincinnati, OH 45221-0108, USA. acquavsa@ucmail.uc.edu
authors: Shauna P
authors: SP
authors: Acquavita
authors: Sandra
authors: S
authors: Stershic
authors: Rajni
authors: R
authors: Sharma
authors: Maxine
authors: M
authors: Stitzer
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration*; D001071:Appointments and Schedules; D003266:Continuity of Patient Care / Q000458:organization & administration*; D032982:Contracts; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D010865:Pilot Projects; D012017:Referral and Consultation; D012052:Reimbursement, Incentive; D015203:Reproducibility of Results; D012201:Reward; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000534:rehabilitation*
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