Assessing continuity of care practices in substance use disorder treatment programs

The purpose of this article is to describe the development and psychometric properties of parallel program-level and individual-level versions of the Continuity of Care Practices Survey (CCPS-P and CCPS-I), a measure that assesses four dimensions of continuity of care practices in substance use disorder (SUD) treatment programs. CCPS subscales assess staff efforts to ensure provider continuity, maintain contact with patients, coordinate care among providers and connect patients to community resources.

Program-level CCPS data were obtained from directors/coordinators of 129 intensive inpatient/residential and outpatient Department of Veterans Affairs SUD programs. These data were used to examine the internal consistency and discriminant validity of the CCPS-P. A parallel individual-level CCPS-I completed by counselors for 835 patients in a subsample of 28 SUD programs, assessed the continuity of care services that staff provided to individual patients. These data were used to examine the predictive validity of the CCPS-P.

CCPS-P and CCPS-I subscales demonstrated acceptable psychometric properties. Lack of significant correlations between CCPS-P subscales and SUD program characteristics (e.g., size, staffing) provided preliminary evidence for discriminant validity. CCPS-P subscales and the overall CCPS-P score predicted corresponding continuity of care services that staff provided to patients within programs, offering support for predictive validity.

Managers can use the CCPS to monitor and improve SUD programs' continuity of care practices. The CCPS also enables researchers to determine the impact of continuity of care practices on the engagement of patients in continuing care and outcomes.