Chapter 3

Trends in Client Characteristics

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Number of Clients

Facility Operation

Type of Care Received

Clients Receiving Methadone/LAAM

 

Substance Abuse Problem Treated

Managed Care

Clients Under Age 18 in Treatment


This chapter presents trends in client characteristics for 1997 to 2003. It should be kept in mind, however, that the facility universe, methods, and survey instrument have changed during this period. These changes are detailed in Appendix C.

Number of Clients

Table 3.1. The number of clients in treatment on the survey reference date increased by 18 percent between 1997 and 2003, from 929,086 in 1997 to 1,092,546 in 2003. The increase is most likely due to improved survey methodology rather than to an actual increase in the number of clients. The principal improvements were an increase in the survey response rate from 86 percent in 1997 to 96 percent in 2003, and an extensive effort to improve the coverage of the facility universe (see Appendix C).

Facility Operation

Table 3.1 and Figure 5. On March 31, 2003, there were 615,410 clients (56 percent of all clients in treatment) in facilities operated by private non-profit organizations, compared with 510,680 clients (55 percent of all clients) in 1997. The number of clients in private for-profit facilities increased from 168,106 (18 percent of all clients) in 1997 to 282,161 (26 percent of all clients) on March 31, 2003. The proportions of clients in government-operated facilities fell between 1997 and 2003—from 13 percent to 9 percent for local government-operated facilities; from 7 percent to 4 percent for State government-operated facilities, and from 5 percent to 3 percent for Federal government-operated facilities. The proportion of clients in tribal government-operated facilities remained constant, at 1 percent.
 

Figure 5
Clients in Treatment by Facility Operation: 1997-2003
Figure 5, Clients in Treatment by Facility Operation: 1997-2003
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Uniform Facility Data Set (UFDS), 1997-1999; National Survey of Substance Abuse Treatment Services (N-SSATS), 2000, 2002-2003.


Type of Care Received

Table 3.2 and Figure 6. The proportions of clients in treatment for the major types of care—outpatient, non-hospital residential, and hospital inpatient—remained relatively stable between 1997 and 2003. There were 968,719 clients (89 percent of all clients) in outpatient treatment on March 31, 2003, compared to 808,956 (87 percent of all clients) in 1997. There were 108,592 clients (10 percent of all clients) in non-hospital residential treatment on March 31, 2003, compared to 103,750 (11 percent of all clients) in 1997. There were 15,235 clients (1 percent of all clients) in hospital inpatient treatment on March 31, 2003, compared to 16,380 (2 percent of all clients) in 1997.
 

Figure 6
Clients by Type of Care Received: 1997-2003
Figure 6, Clients by Type of Care Received: 1997-2003
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Uniform Facility Data Set (UFDS), 1997-1999; National Survey of Substance Abuse Treatment Services (N-SSATS), 2000, 2002-2003.


Clients Receiving Methadone/LAAM

Table 3.2 and Figure 6. The number and proportion of clients receiving methadone/LAAM increased from 138,009 (15 percent of all clients) in 1997 to 229,567 clients (21 percent of all clients) in 2003. Clients receiving methadone/LAAM could be in any type of care.

Substance Abuse Problem Treated

Table 3.3. The proportion of clients in treatment for both drug and alcohol abuse increased from 41 percent in 1997 to 47 percent in 2003. The proportion of clients treated for drug abuse only remained between 27 and 33 percent from 1997 to 2003. The proportion of clients treated for alcohol abuse only declined from 26 percent in 1997 to 20 percent in 2003.

Managed Care

Table 3.4 and Figure 7. In general, the term "managed care" refers to the prepaid health care sector (e.g., HMOs) where care is provided under a fixed budget within which costs are "managed." The trends in the proportion of clients in facilities with agreements or contracts with managed care organizations were grossly similar to those for the proportion of facilities with such agreements or contracts [Table 2.3]. On March 31, 2003, 52 percent of all clients were in facilities with managed care agreements or contracts, and 51 percent of facilities had such agreements or contracts. This represented an increase from 1997, when 47 percent of all clients were in facilities with managed care agreements or contracts, and 46 percent of facilities had such agreements or contracts. The percentage of clients in facilities with managed care agreements or contracts increased between 1997 and 2000 for all facility operation categories. Between 2000 and 2003, however, the proportion of clients in facilities with managed care agreements or contracts generally stabilized or declined slightly. Private non-profit facilities had the highest proportion of clients in facilities with managed care agreements or contracts on March 31, 2003, at 59 percent. Among private for-profit, State, and local government-operated facilities, 46 percent, 45 percent, and 41 percent, respectively, of clients were in facilities with managed care agreements or contracts on March 31, 2003. In facilities operated by tribal governments, 34 percent of clients were in facilities with managed care agreements or contracts. Facilities operated by Federal governments had the lowest proportion of clients in facilities with managed care agreements or contracts, at 16 percent on March 31, 2003.
 

Figure 7
Clients in Facilities with Managed Care Agreements or Contracts: 1997-2003
Figure 7, Clients in Facilities with Managed Care Agreements or Contracts: 1997-2003
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Uniform Facility Data Set (UFDS), 1997-1999; National Survey of Substance Abuse Treatment Services (N-SSATS), 2000, 2002-2003.


Clients under Age 18 in Treatment

Table 3.5 and Figure 8. On March 31, 2003, there were 92,251 clients under age 18 in treatment. These represented 8 percent of all clients. The proportion of clients under age 18 was relatively stable between 1997 and 2003.

The majority of clients under age 18 were in treatment facilities with special programs or groups for adolescents. On March 31, 2003, 78,330 clients under age 18 (85 percent of all clients under age 18) were in treatment facilities with special programs or groups for adolescents. The proportion of clients under age 18 in facilities with special programs or groups for adolescents fluctuated between 1997 and 2003, from a low of 80 percent in 1998 to a high of 90 percent in 2002.
 

Figure 8
Clients under Age 18 and Clients under Age 18 in Treatment
Facilities with Special Programs or Groups for Adolescents:
1997-2003
Figure 8, Clients under Age 18 and Clients under Age 18 in Treatment
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Uniform Facility Data Set (UFDS), 1997-1999; National Survey of Substance Abuse Treatment Services (N-SSATS), 2000, 2002-2003.

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