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Biomedical subjects

W C McCaughrin

Publications and source records attributed to W C McCaughrin.

14 recordsLinked to original sources
PubMed1996

Variation in access to outpatient substance abuse treatment: organizational factors and conceptual issues.

Access is a multidimensional concept representing the ease with which health services are initiated and sustained. In this study, conceptual domains of access--affordability, acceptability, accommodation, availability, service diversity, and competitive stance--are hypothesized to predict the time clients wait to receive services. A large, recently surveyed, nationally representative sample of outpatient substance abuse treatment organizations provided the data. Multivariate regression analysis of 326 organizations was conducted with the conceptual domains sequentially predicting the time clients waited to receive service. Results show that increased waiting time was positively associated with treatment staff case overload and the average number of months clients spent in treatment and negatively associated with the percent of a treatment organization's client base on public assistance. Implications for policy makers and clinicians concerning client selection strategies by organizations and problems with the organizational capacity to treat clients are discussed. Areas for future research also are highlighted.

Adolescent↗
PubMed1996

The effect of social environment on treatment outcomes in outpatient substance misuse treatment organizations: does race really matter?

This study examines whether the racial mix of clients is related to treatment organization outcome rates after controlling for the social environment in which the organization operates. A nationally representative sample of 326 nonmethadone outpatient substance misuser treatment organizations was surveyed in 1990. Unit analysis is the treatment organization. Outcome measures are the percentages of clients who completed and dropped out of treatment. The percent of Black clients treated at the organization, the socioeconomic status of the organization's area, and other client characteristics, organizational factors, and treatment practices are evaluated through multivariate regression to determine their impact on organizational rates of treatment success and failure among clients. Ordinary least-squares regression analysis indicates that race is not a predictor of treatment success once socioenvironmental factors are included in the analysis. Treatment organizations must be wary of defining a person for treatment only in terms of his or her racial or ethnic group membership. Treatment approaches should place more emphasis on the socioenvironmental influences to which the client is exposed and less emphasis on a client's race.

Adult↗
PubMed1996

The treatment effectiveness of outpatient substance misuse treatment organizations between court-mandated and voluntary clients.

Do outpatient substance misuse treatment organizations have different outcomes for court-mandated and voluntary clients depending on the mix of those clients? Do client characteristics, organizational factors, and treatment practices predict organizational treatment outcome rates? A nationally representative sample of 330 nonmethadone outpatient substance misuse treatment organizations was surveyed in 1990. Sixty-four of the organizations had 75% or more court-mandated clients; 122 of the organizations had 25% or less court-mandated clients. Organizations with 75% or greater court-mandated clients had a greater rate of clients failing to comply with their treatment plan than organizations with 25% or less court-mandated clients, but there were no differences in clients meeting the goals of their treatment. Client characteristics, organizational factors, and treatment practices are evaluated through multivariate regression to determine their impact on organizational rates of treatment success and failure among clients.

Adult↗
PubMed1992

Effective outpatient drug treatment organizations: program features and selection effects.

This research identifies program features that predict outpatient drug treatment outcomes. Treatment effectiveness is measured at the organizational level of analysis in a nationally representative sample of non-methadone outpatient drug misuse treatment organizations (N = 394). Multivariate analyses are conducted to identify program features at various stages of the client career that are related to client outcomes after controlling for client characteristics, organizational characteristics, and social area characteristics. Results indicate that effective non-methadone outpatient drug misuse treatment is related to a number of program features including adequate staff levels, quality assurance efforts, and client follow-up, as well as selection factors that reflect client problem severity.

Accreditation↗
PubMed1984

Dollars and sense: the economics of personal health decision-making.

The economic consequences of personal health care decision-making have received relatively little attention in the United States. The majority of the American public is shielded from an awareness of the cost impact of health services by first dollar health insurance coverage and modest out-of-pocket personal payments. As the various current structural changes in the reimbursement system for health care begin to manifest themselves in terms of mandating individual responsibility for paying a significant portion of health care, Americans will require and demand a deeper understanding of how much their health is costing them. In addition, as individuals realize that up to 50% of disability and death can be attributed to negative lifestyle health behaviors, the interrelationship of personal economic status and health status will create a new consciousness of the value of preventive health practices and health education. This article provides an in-depth analysis of the social forces in America compelling individual health decision-making in economic terms, barriers to informed health decision-making, a suggested matrix for making quality-vested health decisions (with case examples) and a discussion of available resources for assisting in the decision-making process.

Community Participation↗
PubMedDate not supplied

The case for patient education: an update on recent court decisions affecting physicians and hospitals.

Recent court decisions directly affect providers of patient education. Legal precedents emerging in the 1980s place increased emphasis on the individual patient in terms of the adequacy of information provided, the patient's level of understanding of that information, and the duty to inform patients of the risks of their refusal to undergo any form of treatment. Specific cases are cited, and the implications of the courts' decisions for providers are delineated. Key legal concepts of American law are reviewed as they relate to patient education, offering a framework for providers of patient education to evaluate their programs and activities with respect to assuring quality and reducing the incidence of litigation.

Hospitals↗
PubMedDate not supplied

Perspective: riddles wrapped in enigma.

Six decades of studies on healthcare quality have persisted in rendering the subject difficult to understand or explain to health researchers and policymakers. This article advances three hypotheses about why quality in healthcare is such an enigma. The first concerns problems with the conceptualization of quality. Issues of uncertainty embedded in quality are discussed in the second hypothesis. Finally, difficulties in understanding quality are discussed within a model offered by the sociology of deviance. The article highlights the contribution of each hypothesis and integrates them into a plausible explanatory framework for quality's elusive comprehensibility.

Accreditation↗