Linkage to medical services in the Drug Abuse Treatment Outcome Study

UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine

Publication Date


Document Type



Episode of Care; Follow-Up Studies; Health Services Accessibility; Humans; *Interinstitutional Relations; Linear Models; Outcome Assessment (Health Care); Patient Satisfaction; Prospective Studies; Questionnaires; Referral and Consultation; Substance Abuse Treatment Centers; Substance-Related Disorders; Transportation; United States


Behavioral Disciplines and Activities | Behavior and Behavior Mechanisms | Community Health and Preventive Medicine | Preventive Medicine


BACKGROUND: An episode of substance abuse treatment is an opportunity to link substance-abusing patients to medical care at a time when management of medical problems might stabilize recovery and long-term health. However, little is known about the ability of organizational linkage mechanisms to facilitate the delivery of medical care to this population.

OBJECTIVES: The goal of this study was to examine whether organizational linkage mechanisms facilitate medical service utilization in drug abuse treatment programs.

RESEARCH DESIGN: This was a prospective secondary analysis of the Drug Abuse Treatment Outcome Study, a national longitudinal study of drug abuse treatment programs and their patients from 1991 to 1993. Hierarchical linear models evaluated the effect of on-site delivery, formal and informal referral, case management emphasis, and transportation on the log-transformed number of medical visits at the 1-month in-treatment patient interview.

MEASURES: Program directors' surveys provided organizational information, including the linkage mechanism used to deliver medical care. Patients reported the number of medical visits during the first month of drug abuse treatment.

RESULTS: Exclusive on-site delivery increased medical utilization during the first month of drug abuse treatment (beta estimate, 0.22; standard error [SE], 0.06; P <0.001). Transportation services also increased 1-month medical utilization (beta estimate, 0.13; SE, 0.03; P <0.001).

CONCLUSIONS: Exclusive on-site delivery of medical services increased drug abuse treatment patients' utilization of medical services in the first month of treatment. Transportation assistance warrants strong policy consideration as a facilitator of medical service delivery. Future research should clarify whether program-level linkage to medical services improves the patient-level outcomes of drug abuse treatment.


Med Care. 2001 Mar;39(3):284-95. Link to article on publisher's website

Journal/Book/Conference Title

Medical care


At the time of publication, Stephenie Lemon was not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID