regulation, employing a case-study approach and linking “the macrosociology of federal policy on opiate addiction to the microsociology of methadone treatment.” Attewell and Gerstein found that some federal policies and regulations resulted in ineffective local management practices and poor outcomes for patients. In this analysis, we found a significant and substantively large negative correlation (r = .725, p < 0.0001) between the proportion of revenues from local government sources and the proportion of patients that receive methadone dosages of 50 mg or higher (shown in clinical research to be more effective) in methadone treatment programs. While we are only exploring associations between funding sources and other program attributes, this is a potentially important result that we will further investigate in analyses that link the program- and patient-level/outcome data.
There were a number of other interesting associations between revenues per client and other treatment and human resources management variables. For example, the provision of primary medical care services to patients (in addition to substance abuse treatment) has been linked in previous studies to improved treatment outcomes. In programs where medical services were delivered (on-site or off-site), revenues per client were significantly higher (p=0.0024, see Table 6). Revenues per client were also higher in SDUs that provide psychiatric care services (p=0.0752). In addition, treatment program effectiveness has also been associated in the literature with the intensity of counseling services. In SDUs that provided group counseling and/or individual counseling more than once per week, revenues per client were significantly higher (p < 0.0001, p=0.0044, respectively). SDUs that provided housing, academic and vocational training, and case management on-site also had higher revenues per client. In general, these results suggest that higher revenues per client might facilitate a more comprehensive treatment approach, that is, the type of approach CSAT was attempting to promote with the demonstration