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. 2018 Feb 1:183:192-200.
doi: 10.1016/j.drugalcdep.2017.11.009. Epub 2017 Dec 16.

Agency-level financial incentives and electronic reminders to improve continuity of care after discharge from residential treatment and detoxification

Andrea Acevedo  1 , Margaret T Lee  2 , Deborah W Garnick  2 , Constance M Horgan  2 , Grant A Ritter  2 , Lee Panas  2 , Kevin Campbell  3 , Jason Bean-Mortinson  4
Affiliations

Agency-level financial incentives and electronic reminders to improve continuity of care after discharge from residential treatment and detoxification

Andrea Acevedo et al. Drug Alcohol Depend. .

Abstract

Background: Despite the importance of continuity of care after detoxification and residential treatment, many clients do not receive further treatment services after discharged. This study examined whether offering financial incentives and providing client-specific electronic reminders to treatment agencies lead to improved continuity of care after detoxification or residential treatment.

Methods: Residential (N = 33) and detoxification agencies (N = 12) receiving public funding in Washington State were randomized into receiving one, both, or none (control group) of the interventions. Agencies assigned to incentives arms could earn financial rewards based on their continuity of care rates relative to a benchmark or based on improvement. Agencies assigned to electronic reminders arms received weekly information on recently discharged clients who had not yet received follow-up treatment. Difference-in-difference regressions controlling for client and agency characteristics tested the effectiveness of these interventions on continuity of care.

Results: During the intervention period, 24,347 clients received detoxification services and 20,685 received residential treatment. Overall, neither financial incentives nor electronic reminders had an effect on the likelihood of continuity of care. The interventions did have an effect among residential treatment agencies which had higher continuity of care rates at baseline.

Conclusions: Implementation of agency-level financial incentives and electronic reminders did not result in improvements in continuity of care, except among higher performing agencies. Alternative strategies at the facility and systems levels should be explored to identify ways to increase continuity of care rates in specialty settings, especially for low performing agencies.

Keywords: Continuity of care; Electronic reminders; Financial incentives; Performance measures; Substance use disorder treatment.

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Conflict of interest statement

Conflict of Interest

Conflicts of interest: None

Figures

Figure 1
Figure 1
Quarterly Average Continuity of Care Rates during Pre-Intervention and Intervention Periods by Research Arm for Detoxification and Residential Treatment
See this image and copyright information in PMC

References

    1. Andersen R, Davidson P. Improving access to care in America: Individual and contextual indicators. In: RM A, TH R, EF K, editors. Changing the U.S. Health Care System: Key Issues in Health Services, Policy, and Management. Jossey-Bass; San Francisco, CA: 2001. pp. 3–30.
    1. Andrzejewski ME, Kirby KC, Morral AR, Iguchi MY. Technology transfer through performance management: The effects of graphical feedback and positive reinforcement on drug treatment counselors’ behavior. Drug Alcohol Depend. 2001;63:179–186. - PubMed
    1. ASAM. The ASAM performance measures for the addiction medicine specialist. 2014 Available at http://www.asam.org/docs/default-source/advocacy/performance-measures-fo... Accessed June 20, 2016.
    1. Averill JB. Matrix analysis as a complementary analytic strategy in qualitative inquiry. Qual Health Res. 2002;12:855–866. doi: 10.1177/104973230201200611. - DOI - PubMed
    1. Blodgett JC, Maisel NC, Fuh IL, Wilbourne PL, Finney JW. How effective is continuing care for substance use disorders? A meta-analytic review. J Subst Abuse Treat. 2014;46:87–97. doi: 10.1016/j.jsat.2013.08.022. - DOI - PMC - PubMed

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