Does Process Improvement in Substance Abuse Treatment Agencies Change Client Outcomes?

Field of Work: Quality improvement for addiction treatment

Problem Synopsis: Youth and adults in the United States with drug or alcohol-related disorders have limited access to high quality treatment. In 2003, only slightly more than 10 percent of Americans age 12 and older who needed treatment actually received it, and, for those who did, the quality of care varied widely.

Synopsis of the Work: From 2008 to 2010, researchers from the Oregon Health & Science University studied the feasibility of using state administrative data systems to assess changes in Medicaid costs and criminal justice system involvement among patients after treatment in five substance abuse treatment agencies in Oregon and Washington state that used process improvement strategies.

All five agencies used a process improvement model developed by NIATx (Network for the Improvement of Addiction Treatment), which uses strategies adapted from private industry to increase the number of people who enter and remain in substance abuse treatment. NIATx is a learning collaborative within the University of Wisconsin-Madison Center for Health Enhancement Systems Studies.

Initial funding for NIATx came from the Robert Wood Johnson Foundation under its national program, Paths to Recovery, and from the federal Center for Substance Abuse Treatment under its STAR (Strengthening Treatment Access and Retention) program. (Four of the five agencies in this study were Paths to Recovery grantees; one was a STAR grantee.)

This project was part of the Robert Wood Johnson Foundation's (RWJF) Substance Abuse Policy Research Program. The program funds research that can help reduce the harm caused by the use of alcohol, tobacco and drugs in the United States.

Key Findings

  • The researchers found:

    • Between September 2003 and December 2007, days between the first client request for services and treatment were significantly reduced from an average of 32 days to 12 days for the five agencies.
    • An average of 90 percent of clients contacting the agencies received an initial assessment. Of those, more than half (57%) completed four subsequent sessions of outpatient treatment.
    • Provider participation in NIATx did not appear to impact overall Medicaid costs, which dropped an average of $3,603 after patients enrolled in substance abuse treatment for one year in the NIATx sites and control sites.