The response of substance use disorder treatment providers to changes in macroeconomic conditions

Research output: Contribution to journalArticle

Abstract

Objective To study how substance use disorder (SUD) treatment providers respond to changes in economic conditions. Data sources 2000–2012 National Survey of Substance Abuse Treatment Services (N-SSATS) which contains detailed information on specialty SUD facilities in the United States. Study design We use fixed-effects regression to study how changes in economic conditions, proxied by state unemployment rates, impact treatment setting, accepted payment forms, charity care, offered services, special programs, and use of pharmacotherapies by specialty SUD treatment providers. Data collection Secondary data analysis in the N-SSATS. Principal findings Our findings suggest a one percentage point increase in the state unemployment rate is associated with a 2.5% reduction in outpatient clients by non-profit providers and a 1.8% increase in the acceptance of private insurance as a form of payment overall. We find no evidence that inpatient treatment, the provision of charity care, offered services, or special programs are impacted by changes in the state unemployment rate. However, a one percentage point increase in the state unemployment rate leads to a 2.5% increase in the probability that a provider uses pharmacotherapies to treat addiction. Conclusions Deteriorating economic conditions may increase financial pressures on treatment providers, prompting them to seek new sources of revenue or to change their care delivery models.

Original languageEnglish (US)
Pages (from-to)59-65
Number of pages7
JournalJournal of Substance Abuse Treatment
Volume81
DOIs
StatePublished - Oct 1 2017

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Substance-Related Disorders
Unemployment
Charities
Economics
Therapeutics
Drug Therapy
Information Storage and Retrieval
Insurance
Inpatients
Outpatients
Pressure

Keywords

  • Economic conditions
  • Health insurance
  • Provider behavior
  • Substance use disorders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Phychiatric Mental Health
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

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title = "The response of substance use disorder treatment providers to changes in macroeconomic conditions",
abstract = "Objective To study how substance use disorder (SUD) treatment providers respond to changes in economic conditions. Data sources 2000–2012 National Survey of Substance Abuse Treatment Services (N-SSATS) which contains detailed information on specialty SUD facilities in the United States. Study design We use fixed-effects regression to study how changes in economic conditions, proxied by state unemployment rates, impact treatment setting, accepted payment forms, charity care, offered services, special programs, and use of pharmacotherapies by specialty SUD treatment providers. Data collection Secondary data analysis in the N-SSATS. Principal findings Our findings suggest a one percentage point increase in the state unemployment rate is associated with a 2.5{\%} reduction in outpatient clients by non-profit providers and a 1.8{\%} increase in the acceptance of private insurance as a form of payment overall. We find no evidence that inpatient treatment, the provision of charity care, offered services, or special programs are impacted by changes in the state unemployment rate. However, a one percentage point increase in the state unemployment rate leads to a 2.5{\%} increase in the probability that a provider uses pharmacotherapies to treat addiction. Conclusions Deteriorating economic conditions may increase financial pressures on treatment providers, prompting them to seek new sources of revenue or to change their care delivery models.",
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author = "Jonathan Cantor and Kenneth Stoller and Brendan Saloner",
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AB - Objective To study how substance use disorder (SUD) treatment providers respond to changes in economic conditions. Data sources 2000–2012 National Survey of Substance Abuse Treatment Services (N-SSATS) which contains detailed information on specialty SUD facilities in the United States. Study design We use fixed-effects regression to study how changes in economic conditions, proxied by state unemployment rates, impact treatment setting, accepted payment forms, charity care, offered services, special programs, and use of pharmacotherapies by specialty SUD treatment providers. Data collection Secondary data analysis in the N-SSATS. Principal findings Our findings suggest a one percentage point increase in the state unemployment rate is associated with a 2.5% reduction in outpatient clients by non-profit providers and a 1.8% increase in the acceptance of private insurance as a form of payment overall. We find no evidence that inpatient treatment, the provision of charity care, offered services, or special programs are impacted by changes in the state unemployment rate. However, a one percentage point increase in the state unemployment rate leads to a 2.5% increase in the probability that a provider uses pharmacotherapies to treat addiction. Conclusions Deteriorating economic conditions may increase financial pressures on treatment providers, prompting them to seek new sources of revenue or to change their care delivery models.

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