title: Performance measures and racial/ethnic disparities in the treatment of substance use disorders.
abstract: OBJECTIVE
  A limited literature on racial/ethnic disparities in the treatment of substance use disorders suggests that quality of treatment may differ based on client's race/ethnicity. This study examined whether (a) disparities exist in the probability of treatment engagement, a performance measure for substance use disorders, and (b) treatment engagement is associated with similar reductions in likelihood of arrest for Whites, Blacks, Latinos, and American Indians.
  
  
  METHODS
  Adult clients who began an outpatient treatment episode in 2008 in public sector specialty treatment facilities in Connecticut, New York, Oklahoma, and Washington made up the sample (N = 108,654). Administrative treatment data were linked to criminal justice data. The criminal justice outcome was defined as an arrest within a year after beginning treatment. Engagement is defined as receiving a treatment service within 14 days of beginning a new outpatient treatment episode and at least two additional services within the next 30 days. Two-step Heckman probit models and hierarchical time-to-event models were used in the analyses.
  
  
  RESULTS
  Black clients in New York and American Indian clients in Washington had significantly lower likelihood of engagement than White clients. As moderators of engagement, race/ethnicity had inconsistent effects across states on the hazard of arrest.
  
  
  CONCLUSIONS
  Racial/ethnic minority groups may benefit from additional treatment support to reduce criminal justice involvement. States should examine whether disparities exist within their treatment system and incorporate disparities reduction in their quality improvement initiatives.
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Andrea
authors.initials: A
authors.lastname: Acevedo
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Garnick
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Robert
authors.initials: R
authors.lastname: Dunigan
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Constance M
authors.initials: CM
authors.lastname: Horgan
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Grant A
authors.initials: GA
authors.lastname: Ritter
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Margaret T
authors.initials: MT
authors.lastname: Lee
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Lee
authors.initials: L
authors.lastname: Panas
authors.affiliation: Washington State Department of Social and Health Services, The Division of Behavioral Health and Recovery, Olympia, Washington.
authors.forename: Kevin
authors.initials: K
authors.lastname: Campbell
authors.affiliation: Connecticut Department of Mental Health and Addiction Services, Hartford, Connecticut.
authors.forename: Karin
authors.initials: K
authors.lastname: Haberlin
authors.affiliation: New York State Office of Alcoholism and Substance Abuse Services, Division of Outcome Management and System Information, Albany, New York.
authors.forename: Dawn
authors.initials: D
authors.lastname: Lambert-Wacey
authors.affiliation: Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City, Oklahoma.
authors.forename: Tracy
authors.initials: T
authors.lastname: Leeper
authors.affiliation: Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City, Oklahoma.
authors.forename: Mark
authors.initials: M
authors.lastname: Reynolds
authors.affiliation: Oklahoma Department of Mental Health and Substance Abuse Services, Oklahoma City, Oklahoma.
authors.forename: David
authors.initials: D
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000553:Ambulatory Care / Q000379:methods; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000628:therapy*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult