The evaluation and research unit has undertaken a number of treatment outcome studies, using both secondary (administrative) and primary data and employing different research designs. Significant resources have been directed to exploration of using linked administrative data from multiple county agencies to evaluate treatment outcomes.
The unit has also conducted randomized field studies to evaluate the long term efficacy of a recently introduced therapeutic track (Health Realization), and of contracted residential and county outpatient treatment programs. These studies have involved post-treatment follow-up of clients, and outcomes data are available from both primary (self reported) sources and administrative agency data.
Finally, targeted reports addressing issues of concern to the department have resulted in reports, primarily instigated by the Continuous Quality Improvement Committee and then disseminated department-wide.
Annual Report 2003
Demographic and treatment related information is reported for clients in the adult system of care.
Outcome Evaluation of DADS Services using Performance Measures from Secondary Data
The activity of adult clients treated from Fiscal Year 1997 to Fiscal Year 2000 in criminal justice, public hospital and ambulatory care clinics, mental health department, and CalWORKS programs, as well as the treatment system, is used to examine treatment outcomes by comparing pre-treatment to post-treatment usage.
Horizon South Residential Facility: Outcome Evaluation
Horizon clients, nine months following admission to treatment, are significantly more likely to be alcohol and drug free, employed, and housed, and to have improved in psychosocial functioning.
Central Treatment and Recovery Outpatient Facility: Outcome Evaluation
Central Treatment & Recovery Outpatient Facility clients, nine months following admission to treatment, are more likely to be alcohol and drug-free, employed, housed, arrest free, and to have improved psychosocial functioning.
Treatment Outcomes and Cost of Dually Diagnosed Clients
Clients who received specialty dual diagnosis services including psychiatric care had better outcomes that those who received only dual diagnosis services, only psychiatric services, or no specialized services, primarily due to their greater length of stay. These clients were also the most expensive to treat.
Treatment Outcomes of Clients Receiving Gender-Specific Group Treatment compared to Clients with no Gender-Specific Group Treatment
Clients in gender-specific groups had no better outcomes than those in mixed groups. Length of stay, however, was a strong predictor of completion of treatment, and there was a non-significant trend likelihood of being abstinent at discharge. Being in gender-specific groups increased the likelihood that a client would remain in treatment for a greater amount of time.
Comparison of Time From Initial Contact to Assessment and Treatment Entry: 2000-2003
The DADS Managed Care system was well on its way toward 72-hour turnaround between initial contact with the gatekeeper and entry into treatment, and appeared to have achieved this for residential clients. However for outpatients the time was being reduced until the introduction of Welcome To Treatment groups designed to provide an orientation to treatment for those on waiting lists when time until actual treatment entry increased to original levels. The proportion of clients actually entering treatment decreased from nearly 2/3 prior to introduction of SACPA to 36% following, although this trend appears to be reversing.
One Year Analysis of SACPA Client Cost
The 2,372 SACPA clients opened for services in FY02 were followed for 365 days. Both treatment and ancillary services, with the exception of Methadone services, were included in the cost analysis. Nearly 11.7 million dollars of service were provided within one year of being admitted as a SACPA client. The median expenditure was $2,779 per client.
Assessment of Santa Clara County SACPA Client Outcomes
The analysis addresses the question of how SACPA client outcomes compare in the one-year period before, the period during treatment, and the one-year period after SACPA treatment. Techniques modeled after the "Outcome Evaluation of DADS Services using Performance Measures from Secondary Data" study were used for the analysis.