title: Race/ethnicity and quality indicators for outpatient treatment for substance use disorders.
abstract: OBJECTIVE
  Initiation and engagement, performance measures that focus on the frequency and timely receipt of services in the early stages of substance use disorders (SUD) treatment, are useful tools for assessing treatment quality differences across racial/ethnic groups. The purpose of this study was to examine whether there are racial/ethnic disparities in these quality indicators and to explore whether predictors of treatment initiation and engagement differ by clients' race/ethnicity.
  
  
  METHODS
  This study used administrative data from outpatient treatment facilities licensed by the state of Massachusetts that receive public funding. The sample consisted of 10,666 adult clients (76% White, 13% Latino, 11% Black) who began an outpatient treatment episode in 2006. Client data were linked with facility data from the National Survey on Substance Abuse Treatment Services. Multilevel regressions were used to examine racial/ethnic disparities and to explore whether predictors for initiation and engagement differed by client's race/ethnicity.
  
  
  RESULTS
  We did not find evidence of racial/ethnic disparities in treatment initiation or engagement. However, we found that predictors of initiation and engagement differed by client's race/ethnicity.
  
  
  CONCLUSIONS
  Disparities may be context specific, and thus it is important that they be examined at state or local levels. Our results point to the importance of examining predictors of quality indicators separately by group to better understand and address the needs of diverse client populations.
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
authors.initials: D
authors.lastname: Garnick
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Grant
authors.initials: G
authors.lastname: Ritter
authors.affiliation: Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
authors.forename: Constance
authors.initials: C
authors.lastname: Horgan
authors.affiliation: Boston University School of Social Work, Boston, Massachusetts.
authors.forename: Lena
authors.initials: L
authors.lastname: Lundgren
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012044:Regression Analysis; D019966:Substance-Related Disorders / Q000628:therapy*; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult