Table 2.
Multivariable Correlates of Accessibility of Outpatient Addiction Treatment*
| Provided Treatment on Demand† | Turned Patients Away‡ | |||
|---|---|---|---|---|
| Odds Ratio | 95% CI | Odds Ratio | 95% CI | |
| Study year | ||||
| 1990 | Referent | Referent | ||
| 1995 | 1.45** | 1.13 to 1.88 | 1.06 | .63 to 1.78 |
| 2000 | 1.95** | 1.47 to 2.57 | .69 | .41 to 1.18 |
| Program characteristics | ||||
| Ownership | ||||
| Public | Referent | Referent | ||
| Private not-for-profit | .85 | .64 to 1.14 | 3.26** | 1.48 to 7.03 |
| Private for-profit | 2.20** | 1.34 to 3.63 | 7.41** | 3.16 to 17.45 |
| Managed care involvement, per 10% | ||||
| Percentage of HMO or PPO patients | 1.08¶ | .99 to 1.18 | 1.11♯ | 1.02 to 1.22 |
| Percentage of patients whose payor required prior authorization | 1.05♯ | 1.01 to 1.09 | 1.08** | 1.02 to 1.16 |
| Methadone provision§ | ||||
| Methadone not available | Referent | Referent | ||
| Short-term methadone | .80 | .54 to 1.21 | 3.26** | 1.69 to 6.37 |
| Methadone maintenance | .65♯ | .42 to .99 | 2.42** | 1.35 to 4.39 |
| Delivery of indigent care, per 10% | ||||
| Percentage of patients who don't pay | .97¶ | .92 to 1.01 | .86** | .78 to .95 |
| Percentage who pay a reduced fee | .95♯ | .94 to .99 | .86** | .83 to .92 |
| Percentage of Medicaid patients | .96♯ | .92 to 1.00 | .93¶ | .84 to 1.01 |
| Mean program age, per 10 years | .86♯ | .75 to .98 | .89 | .72 to 1.10 |
| Mean number of patients, per 100 patients | .99¶ | .97 to 1.00 | .99 | .97 to 1.01 |
| Perceived staff caseload∥ | .76** | .65 to .89 | .80¶ | .61 to 1.00 |
| Client characteristics, per 10% | ||||
| Average age in years | 1.13 | .90 to 1.41 | 1.21 | .86 to 1.68 |
| Percentage of African American patients | 1.01 | .96 to 1.06 | 1.00 | .92 to 1.08 |
| Percentage of Hispanic patients | .99 | .92 to 1.05 | 1.07 | .98 to 1.17 |
| Percentage of polysubstance users | .97¶ | .93 to 1.00 | .97 | .92 to 1.03 |
*
From multivariable logistic generalized estimating equations models with exchangeable correlation structures and robust standard errors.
†
Defined as a supervisor-reported average wait time of 48 hours or less.
‡
Defined as a supervisor report that any patients were turned away.
§
Methadone provision was defined as no methadone available, methadone available with detoxification encouraged after less than 12 months (short-term methadone), or methadone for 12 or more months (methadone maintenance).
∥
The supervisor-rated staff caseload on a five-point scale ranging from “much too low” to “much too high.”
¶
p≤.10
♯
p≤.05
**
p≤.01