Description of Treatment Episode Data Set (TEDS)
|Limitations of TEDS||Interpretation of the Data|
This report presents results from the Treat-ment Episode Data Set (TEDS) for 2003, and trend data for 1993 to 2003.2 The report provides information on the demographic and substance abuse characteristics of the 1.8 million annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual State administrative data systems. The Office of Applied Studies (OAS), Substance Abuse and Mental Health Services Administration (SAMHSA), coordinates and manages collection of TEDS data from the States. (Additional information on TEDS, its history, and its relationship to SAMHSA’s other data collection activities can be found in Appendix A.)
The TEDS system comprises two major components, the Admissions
Data Set and the Discharge Data Set. The TEDS Admissions Data Set is an
established program that has been operational for over 10 years. It includes
data on treatment
admissions that are routinely collected by States to monitor their individual substance abuse treatment systems. The TEDS Discharge Data Set is relatively new, with the first data reported for Year 2000. For both data sets, selected data items from the individual State data files are converted to a standardized format consistent across States. These standardized data constitute TEDS.
The TEDS Admissions Data System consists of a Minimum Data Set collected by all States, and a Supplemental Data Set collected by some States. The Minimum Data Set consists of 19 items that include:
Primary, secondary, and tertiary substances and their route of
administration, frequency of use, and age at first use
Source of referral to treatment
Number of prior treatment episodes
Service type, including planned use of methadone
The Supplemental Data Set consists of 15 items that include psychiatric, social, and economic measures.
The TEDS Discharge Data System was designed to enable TEDS to collect information on entire treatment episodes. Discharge data, when linked to admissions data, represent treatment episodes that enable analyses of questions that cannot be answered with admissions data alone, for example, the proportion of discharges that completed treatment and the average length of stay of treatment completers.
Definitions and classifications used in the Admissions Minimum and Supplemental Data Sets are detailed in Appendix B.
Limitations of TEDS
TEDS, while comprising a significant proportion of all
admissions to substance abuse treatment, does not include all such admissions.
TEDS is a compilation of facility data from State administrative systems. The
scope of facilities included in TEDS is affected by differences in State
licensure, certification, accreditation, and disbursement of public funds. For
example, some State substance abuse agencies regulate private facilities and
individual practitioners, while others do not. In some States, hospital-based
substance abuse treatment facilities are not
licensed through the State substance abuse agency. Some State substance abuse agencies track correctional facilities (State prisons and local jails), while others do not.
In general, facilities reporting TEDS data receive State alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of alcohol and/or drug treatment services. (See Chapter 4.) Most States are able to report all admissions to all eligible facilities, although some report only admissions financed by public funds. States may report data from facilities that do not receive public funds, but generally do not because of the difficulty in obtaining data from these facilities. TEDS generally does not include data on facilities operated by Federal agencies, including the Bureau of Prisons, the Department of Defense, and the Department of Veterans Affairs. However, some facilities operated by the Indian Health Service are included.
The primary goal of TEDS is to monitor the characteristics of treatment episodes for substance abusers. Implicit in the concept of treatment is a planned, continuing treatment regimen. Thus TEDS does not include early intervention programs that are considered to be prevention programs. Crisis intervention facilities such as sobering-up stations and hospital emergency departments generally are not included in TEDS.
TEDS is an exceptionally large and powerful data set. Like
all data sets, however, care must be taken that interpretation does not extend
beyond the limitations of the data. Limitations fall into two broad categories:
those related to the scope of the data collection system, and those related to
the difficulties of aggregating data from highly
diverse State data collection systems.
Limitations to be kept in mind while analyzing TEDS admissions data include:
TEDS is an admission-based system, and TEDS admissions do
not represent individuals. Thus, for example, an individual admitted to
treatment twice within a calendar year would be counted as two admissions.
TEDS attempts to enumerate treatment episodes by
distinguishing the initial admission of a client from his/her subsequent
transfer to a different service type (for example, from residential treatment
to outpatient) within a single continuous treatment episode. However, States
differ greatly in their ability to identify transfers; some can distinguish
transfers within providers but not across providers. (See Chapter 4 and Table
4.1.) Some admission records in fact may represent transfers, and therefore
the number of admissions reported probably overestimates the number of
The number and client mix of TEDS admissions do not
represent the total national demand for substance abuse treatment or the
prevalence of substance abuse in the general population.
The primary, secondary, and tertiary substances of abuse
reported to TEDS are those substances that led to the treatment episode, and
not necessarily a complete enumeration of all drugs used at the time of
States continually review the quality of their data processing. When systematic errors are identified, States may revise or replace historical TEDS data files. While this process represents an improvement in the data system, the historical statistics in this report will differ slightly from those in earlier reports.
Interpretation of the Data
Considerations specific to this report include:
The report includes admissions records for calendar years
1993 to 2003 that were received and processed by SAMHSA through April 11,
SAMHSA, in reporting national-level TEDS data, must balance timeliness of reporting and completeness of the data set. This can result in a time lag in the publication of annual data because preparation of the report is delayed until nearly all States have completed their data submission for that year. Summary statistics for 2004 for those States that have completed their 2004 submissions are available on-line at:
2 The total number of TEDS 2003 admissions has been revised slightly since publication of: Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Treatment Episode Data Set (TEDS). Highlights - 2003. National Admissions to Substance Abuse Treatment Services, DASIS Series: S-27, DHHS Publication No. (SMA) 05-4043, Rockville, MD, 2005. In that reoprt, the number of 2003 admissions was reported as 1,841,522. In preparing this report, it was decided that because the State of West Virginia had reported data for three months of the year only, its data should not be included. This resulted in the reduction of the total number of records by 1,247, to 1,840,275.