Two separate tracks ? A national multivariate analysis of differences between public and private substance abuse treatment programs

FRANÇAIS :
Cette étude pointe les différences entre les programmes publics et privés de traitement de l'usage de drogues aux Etats-Unis. Ainsi les programmes mis en place par l'état, le gouvernement local et les organismes à but non lucratif ont plus de personnels, mais les programmes privés et fédéraux emploient plus de psychologues et de médecins. En ce qui concerne la majorité des traitements, les organismes privés ont des programmes plus courts sauf pour la substitution à la méthadone, et plus orientés vers un seul type de traitement. Ces programmes privés reçoivent plus de subventions de l'assurance privée ainsi que plus d'honoraires de leurs patients. Les programmes des organismes à but non lucratif ont des caractéristiques qui les placent entre les organismes privés et les organismes publics. Selon les auteurs, les programmes privés pourraient représenter le futur des traitements de l'abus de drogues.
ENGLISH :
Objective: This study describes differences between public and private substance abuse treatment programs. Results: Programs operated by state and local government and nonprofit agencies had more staff, but federal and for-profit programs employed more psychologists and medical doctors. We found that, in most treatment settings, for-profit programs were smaller and more likely to specialize in providing treatment in a single setting. Methadone maintenance programs were larger when operated under for-profit ownership, however. For-profit programs received more funding from private insurance and client fees. Conclusions: We found substantial differences between public and private programs, but this division was not strictly dichotomous. Federal programs differed from public programs oper- ated by state and local governments. Programs operated by nonprofit agencies had characteristics that placed them between private for-profit and public programs. State and local agencies are contracting with private managed behavioral health care organizations to Provide Substance abuse treatment and other mental health care. The characteristics of for-profit programs may represent the future direction of substance abuse treatment. (From the author' s abstract)