Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality
Article first published online: 18 NOV 2011
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 3pt1, pages 1068–1090, June 2012
How to Cite
Fields, D., Roman, P. M. and Blum, T. C. (2012), Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality. Health Services Research, 47: 1068–1090. doi: 10.1111/j.1475-6773.2011.01352.x
- Issue published online: 8 MAY 2012
- Article first published online: 18 NOV 2011
- National Institute on Drug Abuse
- Internal management practices;
- quality management;
- substance use disorder treatment quality;
- behavioral health services
To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment.
Data Sources/Study Setting
Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS).
The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance.
Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008.
Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient.
Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present.