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Case Management and Client Access to Health and Social Services in Outpatient Substance Abuse Treatment

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Abstract

A primary goal of case management is to coordinate services across treatment settings and to integrate substance abuse services with other types of services offered in the community, including housing, mental health, medical, and social services. However, case management is a global construct that consists of several key dimensions, which include extent of case management coverage, the degree of management of the referral process, and the location of case management activity (on-site, off-site, or both). This study examines the relationship between specific dimensions of case management and the utilization of health and ancillary social services in outpatient substance abuse treatment. In general, results suggest that more active case management during the referral process and providing case management both on-site and off-site are most consistent with our predictions of greater use of health and ancillary social services by substance abuse clients. However, these effects are specific to general health care and mental health services. Case management appears to have little effect on use of social services or aftercare plans.

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Notes

  1. To create the case management referral index, factor analysis was employed, which used a standard threshold value of 1.0 for the eigenvectors. The CM practice index was well captured with a single index, with approximately equal loading of all three referral variables. Using the method of principal factors, the first eigenvalue obtained a value of 1.96, with subsequent factor eigenvalues below 0.2 in absolute value, indicating that a single-factor model captures much of the variance in the three terms.

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Acknowledgment

This research was supported by grants 5R01-DA03272, 5R01-DA087231, and 5R01-DA003272-20 from The National Institute on Drug Abuse.

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Authors and Affiliations

  1. Department of Health Management and Policy, The University of Michigan, 109 S. Observatory, Ann Arbor, MI, 48109-2029, USA

    Jeffrey A. Alexander PhD & Tammie Nahra PhD

  2. School of Social Service Administration, University of Chicago, 969 East 60th Street, Chicago, IL, 60637, USA

    Harold Pollack PhD

  3. School of Public Health, University of North Carolina, 1104F McGavran-Greenberg Hall, Chapel Hill, NC, 27599-7411, USA

    Rebecca Wells PhD

  4. Department of Health Services Research, Management and Policy, The University of Florida, P.O. Box 100195, Gainesville, FL, 32610-0195, USA

    Christy Harris Lemak PhD

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  1. Jeffrey A. Alexander PhD
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Correspondence to Jeffrey A. Alexander PhD.

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Alexander, J.A., Pollack, H., Nahra, T. et al. Case Management and Client Access to Health and Social Services in Outpatient Substance Abuse Treatment. J Behav Health Serv Res 34, 221–236 (2007). https://doi.org/10.1007/s11414-007-9072-4

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