Comparison of outcomes by gender and for fee-for-service versus managed care A study of nine community programs

Women, Co-occurring Disorders, and Violence Study: Evaluation design and study population

“…The mean baseline ASI alcohol composite score was .20, which is similar to other treatment-seeking substance abuse samples (Alterman, Randall, & McLellan, 2000;McLellan et al, 1992). The ASI alcohol composite for women in a cross-section of treatment programs from several studies ranged from .10 to .63 (McLellan et al, 1992).…”

Substance abuse treatment entry, retention, and outcome in women: A review of the literature

“…While concerns have been raised about the effectiveness of substance abuse treatment for women (Ferrence et al, 1994;Floyd et al, 1996;Hodgins et al, 1997;Schmidt and Weisner, 1995;Schober and Annis, 1996), many studies have found few or no gender differences in treatment outcome across various populations (e.g., Acharyya and Zhang, 2003;Alterman et al, 2000;Ballesteros et al, 2004;Benishek et al, 1992;Foster et al, 2000;Green et al, 2004;Greenfield et al, 1998;Hser et al, 2003;Jerrell and Ridgely, 1995;Marsh et al, 2004;McCance et al, 1999;McLellan et al, 1994;Rohsenow et al, 2000;Sterling et al, 2004;Toneatto et al, 1992;Wong et al, 2002). For example, one recent report (Acharyya and Zhang, 2003) found treatment-related improvements, but only minimal differences in outcomes between men and women in four substance abuse treatment modalities (methadone, non-methadone outpatient, short-term inpatient, and longterm residential).…”

“…Predictors, however, often varied by gender and included educational attainment (Greenfield et al, 2003), self-efficacy (Greenfield et al, 2000), co-occurring major depression (Greenfield et al, 1998), and a history of sexual abuse . Another study (Alterman et al, 2000) compared treatment outcomes for cocaine-or alcohol-dependent men and women receiving treatment in managed care versus fee-for-service settings and found no gender differences in outcomes. A study of gender differences in DSM-IV alcohol-dependent inpatients admitted for detoxification (Foster et al, 2000) found significant baseline gender differences: women reported being of higher social class, having been prescribed antidepressants during the prior 12 months, drinking less in a typical week, and being more likely to screen positive for psychiatric problems.…”

Access To Services: Multiple Perspectives From Adults With Substance Abuse Disorders In Massachusetts

“…Comparing access before and after the introduction of managed care in the Oregon Health Plan showed that access to substance abuse treatment improved after moving to managed care (Deck, McFarland, Titus, Laws, & Gabriel, 2000). Other studies have shown no differences in access or outcomes due to managed care, despite significant cost savings from reductions in some levels of care (Alterman, Randall, & McLellan, 2000;Renz, Chung, & Fillman, 1995;Rohrer, Rohland, Westermann, Knott, & Zwick, 1999). However, these reports cannot dispel most concerns about the impact on particular groups of patients (McNeese-Smith, 1998), and do not address the impact on clients' perceptions of getting care when needed.…”