Our goal is to apply research methods to the purpose of improving the public alcohol treatment system. The two major generic aims of this project are to learn more about the patterns of service utilization for clients in the public alcohol treatment system in King County/Seattle, Washington, and to investigate methods for how best to communicate these findings to the persons responsible for managing this treatment system, so that they might make more informed administrative decisions. Regarding the former, we will obtain two types of data from existing state computerized information Systems. For all clients receiving publicly funded alcohol or drug (AD) treatment services in King County, we will have detailed data on all AD services received. We will also obtain data on a more aggregated level for services received from other state sources, including mental health, welfare (including SSI), medical payments (including Medicaid), social services, Employment Security (records of income from work) and Vital Statistics. The AD data will be analyzed for patterns of client movement among components of the treatment system, and the results will be input to a computerized model of the treatment system which we have partly developed and will continue to develop during the project. When the model is adequately validated, we will use it to pose questions about how the treatment system might perform under hypothetical conditions, such as varying patterns of resource allocation, or when different or new interventions are introduced, or when services are organized in new ways. The utilization data for the services other than AD will be used to evaluate overall outcomes and costs of services for these clients, and variations in these for clients who follow different paths through the system. All of these results will be provided to the County managers of the system, including members of the Administrative Board. The usefulness of the various kinds of information to decision-making will be evaluated, and we will explore for other possible types of data or ways to present data that might be more useful. This project should have the effect of identifying the types of services utilization data which are particularly important in describing system behavior, and which should therefore be especially useful to decision makers in managing the system. This, in turn, should improve the effectiveness and efficiency of the treatment system, giving more clients better access to better quality care.
