Does Meeting the HEDIS Substance Abuse Treatment Engagement Criterion Predict Patient Outcomes?
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This study examines the patient-level associations between the Health Plan Employer Data and Information Set (HEDIS) substance use disorder (SUD) treatment engagement quality indicator and improvements in clinical outcomes. Administrative and survey data from 2,789 US Department of Veterans Affairs SUD patients were used to estimate the effects of meeting the HEDIS engagement criterion on improvements in Addiction Severity Index Alcohol, Drug, and Legal composite scores. Patients meeting the engagement indicator improved significantly more in all domains than patients who did not engage, and the relationship was stronger for alcohol and legal outcomes for patients seen in outpatient settings. The benefit accrued by those who engaged was statistically significant but clinically modest. These results add to the literature documenting the clinical benefits of treatment entry and engagement. Although these findings only indirectly support the use of the HEDIS engagement measure for its intended purpose—discriminating quality at the facility or system level—they confirm that the processes of care captured by the measure are associated with important patient outcomes.
Keywordshealth care delivery substance abuse services veterans performance measures standards of quality HEDIS
This study was funded by the Center for Substance Abuse Treatment (Contract 270-02-7120), and the VA Office of Research and Development Health Services Research and Development Service (grants no. SUS 99-015, MRP-05-168-1, IIR-07-092-1). Keith Humphreys is a member of the Washington Circle and Alex Harris is a member of the Washington Circle Public Sector Workgroup. The opinions expressed are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the Center for Substance Abuse Treatment.
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