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2007 National Survey of Substance Abuse Treatment Services (N-SSATS)

Chapter 1
Description of the National Survey of Substance Abuse Treatment Services (N-SSATS)

Data Collection Procedures for the 2007 N-SSATS
  Field period and reference date   Survey coverage   Content
Data collection Forms accounting and response rate Exclusions from the 2007 N-SSATS Report
Number of respondents reporting facility and client data Quality assurance Item non-response
Methodology of Imputation of Missing Data and Outliers Further Data Considerations and Limitations Organization of the Report
Terminology    

This report presents tabular information and highlights from the 2007 National Survey of Substance Abuse Treatment Services (N‑SSATS), conducted between March and October 2007, with a reference date of March 30, 2007. It is the 30th in a series of national surveys begun in the 1970s. The surveys were designed to collect data on the location, characteristics, and utilization of alcohol and drug treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions.1 The Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, plans and directs N-SSATS.

N-SSATS is designed to collect information from all facilities2 in the United States, both public and private, that provide substance abuse treatment. (Additional information on N-SSATS, its history, and changes in the survey and survey universe over time is provided in Appendix A.)

N-SSATS provides the mechanism for quantifying the dynamic character and composition of the U.S. substance abuse treatment delivery system. The objectives of N-SSATS are to collect multipurpose data that can be used to —

http://findtreatment.samhsa.gov

Data Collection Procedures for the 2007 N-SSATS

Field period and reference date

The field period for the 2007 N-SSATS ran from March 30, 2007, through October 17, 2007, with a reference date of March 30, 2007.

Survey coverage

The 2007 N-SSATS facility universe included all 16,146 active treatment facilities on SAMHSA’s I‑SATS at a point 6 weeks before the survey reference date. There were 627 facilities added by State substance abuse agencies or discovered during the first 3 weeks of the survey that were also included in the survey universe, increasing the total survey universe to 16,773.

Content

The 2007 N-SSATS survey instrument was a 12-page document with 47 numbered questions. (See Appendix B.) Topics included:

Data collection

Six weeks before the survey, letters were mailed to all facilities to alert them to expect the survey. An additional purpose of the letters was to update records with new address information received from the Post Office. On the survey reference date, data collection packets, including the questionnaire, SAMHSA cover letter, State-specific letter of endorsement, information on completing the survey on the Internet, and a sheet of Frequently Asked Questions, were mailed to each facility. During the data collection phase, contract personnel were available to answer facilities’ questions concerning the survey. Support in responding to questions for those facilities completing the questionnaire over the Internet was also available. Four to 5 weeks after the initial questionnaire mailing, thank you/reminder letters were sent to all facilities. Approximately 8 weeks after the initial questionnaire mailing, non- responding facilities were sent a second questionnaire mailing. About 4 to 5 weeks after the second questionnaire mailing, non-respondents received a reminder telephone call. Those facilities that had not responded within 2 to 3 weeks of the reminder call were telephoned and asked to complete the survey by telephone. The overall response rate was 94.5 percent.

Forms accounting and response rate

Table 1.1 presents a summary of response rate information. Questionnaires were mailed to a total of 16,773 facilities believed to be actively providing substance abuse treatment services. Of these facilities, 9.4 percent were found to be ineligible for the survey because they had closed or did not provide substance abuse treatment or detoxification on March 30, 2007. Of the remaining 15,188 facilities, 94.5 percent completed the survey.

Table 1.1
N-SSATS forms accounting, response rate, and mode of response: 2007

  Number Percent
Total facilities in survey 16,773 100.0
Closed/Ineligible  1,585   9.4
Eligible 15,188  90.6
Total eligible 15,188 100.0
Non-respondents    829   5.5
Respondents 14,359  94.5
Excluded from Report1    408   2.7
Roll-ups2    303   2.0
Included in Report 13,648  89.9
Mode of Response 13,648 100.0
Internet  6,010  44.0
Mail  4,844  35.5
Telephone  2,794  20.5
     
1 Facilities deemed out of the scope of this report. See text for details.
2 Facilities whose client counts were included in or “rolled into” other facilities’ counts and whose facility characteristics were not reported separately.

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS), 2007.

Exclusions from the 2007 N-SSATS Report

The N-SSATS survey serves several purposes, as noted earlier, and 408 of the 14,359 survey respondents provided information but were deemed out of the scope of this report. They were excluded from the analyses presented here. The excluded facilities and reasons for exclusion fell into three categories:

An additional 303 facilities whose client counts were included in or “rolled into” other facilities’ counts and whose facility characteristics were not reported separately were excluded from facility counts in this report. However, their client counts are included.
After the exclusion of 408 out-of-scope facilities and 303 rolled-up facilities, 13,648 eligible respondent facilities were included in the 2007 ­N‑SSATS report.

Number of respondents reporting facility and client data

Table 1.2. There were 13,648 eligible respondents to the 2007 N-SSATS. The breakdown of facility data and client counts reported by these respondents is summarized below.

Table 1.2
Number of N-SSATS facilities reporting client and/or facility data: 2007
Type of data reported Number of facilities for which facility characteristics were reported1 Number of facilities for which client counts were reported
Total 13,648 13,211
Facility characteristics and client counts for responding facility only 11,890 11,885
Facility characteristics for responding facility only; client counts for responding facility and other facilities as well    665  1,326
Facility characteristics only (client counts reported by another facility)  1,093    0
1 Excludes 188 non-treatment half way houses, 70 facilities treating incarcerated clients only, and 155 non-State approved solo practitioners.
SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS), 2007.

Quality assurance

All mail questionnaires were reviewed manually for consistency and for missing data. After data entry, automated quality assurance reviews were conducted. These incorporated the rules used in manual editing, plus consistency checks and checks for data outliers not readily implemented by manual review. Calls were made to facilities to clarify questionable responses and to obtain missing data.

If facilities could not be reached during the edit callbacks, responses that were clearly in error were replaced by imputation.

The Internet questionnaire was programmed to be self-editing; that is, respondents were prompted to complete missing responses and to confirm or correct inconsistent responses.

Item non-response

Careful editing and extensive follow-up have minimized item non-response. (See Appendix C.) Item non-response was generally low, averaging 3 percent across all items. It was 10 percent or more for only 13 items.

Missing data for client count variables (i.e., the number of clients in hospital inpatient, residential (non-hospital), and outpatient treatment, and their subcategories) were imputed, as were total annual admissions. Facilities with missing values for non-imputed variables were excluded from the tabulations using those variables. As a result, the numbers of treatment facilities on which tables are based may vary somewhat from table to table. The total number of facilities is generally included on each table.

Methodology of Imputation of Missing Data and Outliers

As noted above, client count variables (i.e., the number of clients in the different service types) and total annual admissions were candidates for imputation.

A total of 92 facilities were missing one-day client census counts for one or more types of service. An imputed value for a type of service was given if a facility reported that it provided the service but had not provided a client count for the service. For example, if a facility reported that it provided hospital inpatient and outpatient services, but not residential (non-hospital) services, client values were imputed for the hospital inpatient and outpatient counts only.

Outliers were identified as cases where the number of clients reported exceeded the 75th percentile of the distribution of client counts for all cases of one of the main service types. The 2007 value was compared with the average of previous years’ data. If the difference exceeded 1.8 times the 2007 value in either direction, the value was imputed.

When available, client values from the 2006 ­N‑SSATS were used to impute the missing client counts on the 2007 N-SSATS. In all other cases, the average client value, stratified by State and facility operation, was used to impute the missing client counts. If a facility were unique in its State and facility operation category, values were imputed using average values for the State only. Missing client counts were imputed for each type of service (i.e., hospital inpatient detoxification, hospital inpatient treatment, residential (non-hospital) detoxification, etc.) and summed to the larger service type totals (total hospital inpatient clients, total residential (non-hospital) clients, and total outpatient clients), and finally to total clients.

Further Data Considerations and Limitations

As with any data collection effort, certain procedural considerations and data limitations must be taken into account when interpreting data from the 2007 N-SSATS. Some general issues are listed below; other considerations are detailed in Appendix A. Considerations and limitations of specific data items are discussed where the data are presented.

Organization of the Report

The balance of this report is organized into five sections. Chapter 2 presents trends in facility characteristics for 2003 to 2007.
Chapter 3 presents trends in client characteristics for 2003 to 2007. Chapter 4 describes key characteristics of facilities and the programs and services they provide. Chapter 5 describes key characteristics of clients in substance abuse treatment on March 30, 2007. Finally, Chapter 6 presents State-level detail for most of the tables presented in Chapters 4 and 5. Appendix A provides additional information on N-SSATS, its history, and changes in the survey and survey universe over time. Appendix B contains the 2007 N-SSATS mail survey. Appendix C contains a table of item response rates.

Terminology

The majority of tables in the report are organized by facility operation and by primary focus of the facility. Therefore, it is important to define these terms.

Facility operation indicates the type of entity responsible for the operation of the facility: private for-profit; private non-profit; or government—local, county, or community; State; Federal; or tribal.

Primary focus indicates the services the facility primarily provides: substance abuse treatment services; mental health services; a mix of mental health and substance abuse treatment services; general health care; or other.

Clients in treatment were defined as: 1) hospital inpatient and residential (non-hospital) clients receiving substance abuse services at the facility on March 30, 2007; and 2) outpatient clients who were seen at the facility for a substance abuse treatment or detoxification service at least once during the month of March 2007, and who were still enrolled in treatment on March 30, 2007.


1 The jurisdictions include the territory of Guam, the Federated States of Micronesia, the Republic of Palau, the Commonwealth of Puerto Rico, and the Virgin Islands of the United States.
2 In this report, entities responding to N-SSATS are referred to as “facilities.” As discussed later in the report, a “facility” may be a program-level, clinic-level, or multi-site respondent.

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This page was last updated on January 30, 2009.