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improved patient outcomes.  In response to the findings that a majority of treatment units had methadone dosages below effective levels and an inadequate average length of time in treatment, the Center for Substance Abuse Treatment, the National Institute on Drug Abuse and the Institute of Medicine had worked to establish and communicate guidelines for improved methadone treatment practices.  In this follow-up, the population of methadone maintenance treatment units was stratified according to ownership (public, private for-profit, private nonprofit)

Friedman, Alexander and D’Aunno (1997) used an expanded set of organizational measures from the ODATS (cross-sectional) study to examine the relationship of six program-level factors (ownership, affiliation, resources, leadership, program philosophy and staffing) to the delivery of primary care and mental health services in substance abuse treatment units, (services that are positively linked to treatment outcomes.)  The dependent variable in their study was a measure of patient access to health services during their tenure in the substance abuse treatment unit.  Multivariate analyses showed a “tendency toward better access to services in public units, units with more human resources, and JCAHO-accredited units.” (15)  They found that for-profit programs delivered fewer ancillary health services but also pointed out that patients in for-profit programs were generally less disadvantaged, limiting conclusions about ownership and service provision.  Some surprising findings were the absence of a relationship between hospital or mental health center affiliation and primary care and mental health services delivery.  They concluded with a recommendation for more research on whether and how organizational factors can be manipulated to improve patients’ access to these health care services (on-site or off-site.)

In these and other studies that use the ODATS data, the process or complex interactions through which structure and management influence treatment practices and ultimately patient outcomes

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