Discharge Status as a Performance Indicator: Can It Predict Adolescent Substance Abuse Treatment Outcome?

ABSTRACT

Several market forces including the federal government (Government Performance and Results Act of 1993), managed behavioral health care, and accreditation organizations such as JCAHO, NCQA, and CARF are placing increasing emphasis on substance abuse treatment programs to use performance indicators to monitor quality of outcomes. Discharge status is a frequently cited performance indicator with high intuitive appeal to serve as a low-cost proxy indicator of therapeutic outcome. Researchers are just beginning to address the relationship of discharge status to therapeutic outcomes for adolescents treated for substance abuse. The purpose of the present study was to assess the relationship between discharge status and therapeutic outcomes after discharge from a residential treatment program for adolescents. Eighty-six clients were categorized based on the discharge status assigned to them by the treatment program and interviewed using the Global Appraisal of Individual Needs (GAIN) questionnaire at intake and 90 days after discharge. Results of this study did not indicate superior outcomes for the planned discharge group. Both groups significantly decreased their days of use, heavy use, and problems related to alcohol and other drug use. Several issues are raised regarding the use of discharge status as a performance indicator and recommendations are made for further research in this area.

KEYWORDS:

• Adolescent substance abuse
• discharge status
• performance indicators
• treatment outcome