Table 2. Trends in 15 National Methadone Maintenance Treatment Programme performance metrics before and after human resource development and capacity-building activities, China, 2004–2011.
| Performance metric | Before |
After |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | ||
| No. of clinics in operation | 8 | 58 | 320 | 503 | 600 | 680 | 701 | 738 | |
| No. of clients per clinic, mean | 110 | 115 | 82a | 115 | 156 | 166 | 174 | 190 | |
| No. of clients per clinic, range | 24–208 | 2–486 | 1–732 | 1–1336 | 1–1429 | 1–1338 | 1–1398 | 1–1367 | |
| Staff to client ratiob | 1:32 | 1:4 | 1:9 | 1:16 | 1:20 | 1:26 | 1:28 | 1:34 | |
| Cumulative no. of clients | 1220 | 8116 | 37 345 | 97 554 | 178 684 | 241 975 | 295 182 | 344 254 | |
| Clients still on treatment as of end of year | 878 | 6676 | 26 165 | 57 947 | 93 773 | 112 831 | 122 032 | 140 102 | |
| Annual client retention rate (%)c | 72.6 | 70.1 | 75.8 | 71.7 | 69.5 | 65.6 | 70.3 | 74.9 | |
| Mean duration in treatment (days)d | 93 | 114 | 120 | 170 | 196 | 216 | 232 | 238 | |
| Mean daily methadone dose (mg)d | 47.2 | 47.4 | 48.8 | 49.2 | 50.7 | 53.3 | 56.5 | 58.6 | |
| SE of mean daily methadone dose (mg) | 18.3 | 23.0 | 23.0 | 25.4 | 26.1 | 27.9 | 29.8 | 31.0 | |
| Rate of concurrent opioid use (%) | 7.6e | 12.4e | 21.8 | 23.7 | 26.4 | 24.5 | 24.0 | 23.6 | |
| HIV testing rate (%)f | – | – | – | – | – | – | 61.6 | 78.8 | |
| HCV testing rate (%)f | – | – | – | – | – | – | 61.4 | 77.8 | |
| Syphilis testing rate (%)f | – | – | – | – | – | – | 56.5 | 76.0 | |
| Total annual provider training costs (US$)g | 142 000 | 407 000 | 442 000 | 497 000 | 301 000 | 322 000 | 313 000 | 513 000 | |
HCV, hepatitis C virus; HIV, human immunodeficiency virus; SE, standard error; US$, United States dollars.
a Owing to the rapid increase in the number of clinics that opened in 2006, this mean is lower than the mean in previous and subsequent years. Before 1 July 2006, this mean was 106; after 1 July 2006 it dropped to 53.
b Staff-to-client ratios are for Yunnan province only; these data are not yet available at the national level.
c To calculate the annual client retention rate, we divided the total number of clients who received at least one methadone dose in December by the total number of clients who had received at least one methadone dose during the entire year (minus those who had died).
d The Pearson Correlation coefficient t-test showed a statistically significant increase over time (P < 0.0001).
e Rates of concurrent drug use are artificially low in 2004 and 2005 because monthly random urine opioid tests were not carried out consistently. The problem was resolved by strictly implementing random urine opioid testing in late 2005.
f No data on testing for HIV infection, hepatitis C virus infection or syphilis were available before 2010.
g Currency conversion rates used: US$ 1 = 8.27 yuan renminbi (CNY) in 2004; US$ 1 = 8.07 CNY in 2005; US$ 1 = 8.01 CNY in 2006; US$ 1 = 7.51 CNY in 2007; US$1 = 6.82 CNY in 2008–2010; US$1 = 6.33 CNY in 2011.