A study of the determinants of alcoholism treatment referral

Recent concerns of cost-containment and effectiveness of treatment of alcoholics have emphasized the need to match clients to treatment resources more adequately. Indeed, legislation was passed in Oregon mandating insurance reimbursement for the most appropriate and least costly alcoholism and alcohol abuse treatment. As a result, the Oregon State Health Planning and Development Agency (SHPDA) developed an instrument to assess the appropriate level of care for each client.

This study addressed three hypotheses: (1) The descriptive statements of the SHPDA instrument, as designed and organized, are strongly and positively associated with treatment setting choice; (2) Medically and psychiatrically oriented sets of descriptive statements in the SHPDA instrument will account for more error in predicting treatment setting choices than socially oriented descriptive statements; and (3) Personal characteristics of respondents using the SHPDA instrument will significantly affect choices of treatment setting.

Low response rates yielded a sample that precluded usual statistical tests of significance, leaving only measures of association for use in analysis of results. As a result of the sample size, all results must necessarily be viewed as trends for further investigation.

The first hypothesis was not upheld. Although the SHPDA instrument was designed to reflect a continuum of severity of alcoholic symptoms in its descriptive statements, measures of association of these descriptive statements with level of care were weak at best.

The second hypothesis received some support. Medically and psychiatrically oriented groups of descriptive statements showed relatively stronger measures of association with the level of care chosen when compared to like measures of association for socially oriented groups of descriptive statements.

The third hypothesis was not examined due to inadequate sample size.