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Resumo
The Alcoholism Service System of the State of Nebraska was evaluated for adherence to Continuity of Care guidelines that have been set forth by the State alcohol authority. The guidelines are as follows: (1) inclusion of appropriate termination information at the end of each service provided; (2) provision of multiple services in a sequence of treatment restrictiveness; and (3) maintenance of an effective referral network.
The treatment records of clients who received more than one type of service within the State system (N = 1,056) during a one-year period were assessed for adherence to the guidelines, using a stepwise sorting procedure. This procedure sorted client records into four mutually exclusive groups reflecting clients who had received services in accordance with none, one, two or all three guidelines. As sorting criteria, the guidelines were considered in linear fashion, so that, for example, non-adherence to guideline number one excluded a record from consideration with respect to the other guidelines. The four Experimental Sort Groups were then examined on the basis of twenty-three demographic variables available from the Nebraska Alcohol Information System (NAIS). These are client data sheets which are completed at the time of each admission into treatment. The demographic characteristics are related to greater adherence to the guidelines as they are examined in this study.
The data indicate that service providers must make clinical inferences on the basis of the initially obtained demographic data to determine what factors must be given special consideration to increase a client's chances of receiving care in accordance with Continuity guidelines. These factors include life stability, personal support systems, region of origin, ethnicity, age and source of reason for the client's referral into treatment. Finally, implications of the present procedure for future use in monitoring efforts are discussed.
