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Community Context and Healthcare Quality: The Impact of Community Resources on Licensing and Accreditation of Substance Abuse Treatment Agencies

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Abstract

This study examines variation in healthcare quality among substance abuse treatment agencies. Using an organizations framework, the authors predict that resource advantages benefit certain types of healthcare organizations, especially those located in affluent communities. As a result, levels of licensing and accreditation of substance abuse treatment agencies will differ across United States counties. The authors model these resources at both the organizational and community levels in an effort to understand the variability of licensing and accreditation between agencies and their local contexts. In multivariate models, the findings confirm that organizational characteristics such as private ownership (compared to public ownership), managed care contracts, inpatient and residential programs (compared to outpatient settings), as well as socioeconomic, racial/ethnic, and healthcare system advantage promote higher levels of licensing and accreditation. Public ownership and outpatient settings, as well as socioeconomic, racial/ethnic, and healthcare system disadvantage, are associated with lower levels of licensing and accreditation.

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Notes

  1. Thanks to an anonymous reviewer for this point.

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Acknowledgments

The authors would like to thank Kendralin Freeman of Hobart and William Smith Colleges and Sonal Nalkur of Emory University for data collection; Lloyd Liang and Daniel Hussey for their editorial assistance; and several anonymous reviewers for their helpful comments.

Conflict of Interest Statement

The authors declare that no conflict of interest exists with regard to this manuscript. We did not receive any financial support from outside funders to complete this research project.

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Authors and Affiliations

  1. Department of Sociology, Colby College, Waterville, ME, USA

    Matthew E. Archibald PhD

  2. Organizational Leadership Program, University of Maryland Eastern Shore, Princess Anne, MD, USA

    Caddie Putnam Rankin PhD

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  1. Matthew E. Archibald PhD
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  2. Caddie Putnam Rankin PhD
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Correspondence to Matthew E. Archibald PhD.

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Archibald, M.E., Putnam Rankin, C. Community Context and Healthcare Quality: The Impact of Community Resources on Licensing and Accreditation of Substance Abuse Treatment Agencies. J Behav Health Serv Res 40, 442–456 (2013). https://doi.org/10.1007/s11414-013-9340-4

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