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Rural hospital-based alcohol and chemical abuse services: availability and adoption, 1983-1988
S S Mick1, L L Morlock, D Salkever
1School of Public Health, University of Michigan, Ann Arbor 48109-2029.
Journal of Studies on Alcohol
|July 1, 1993
Summary
Few rural U.S. hospitals offered alcohol and chemical abuse (ACA) services, with less than 19% providing them. The scarcity of psychiatric personnel was a key factor limiting rural hospital-based ACA service availability.
Area of Science:
- Health Services Research
- Rural Health
- Substance Abuse Treatment
Background:
- Limited availability of alcohol and chemical abuse (ACA) services in rural U.S. hospitals was observed.
- Existing services were often recently established, with few plans for future expansion.
Purpose of the Study:
- To investigate the prevalence and correlates of alcohol and chemical abuse (ACA) services in rural U.S. hospitals.
- To identify factors associated with the provision of ACA services in rural healthcare settings.
Main Methods:
- Retrospective panel study of 797 rural U.S. hospitals between 1983-1988.
- Bivariate analysis and multivariable logistic regression were employed to identify significant associations.
Main Results:
- Only 18.7% of rural hospitals offered ACA services, with limited plans for new service development.
- Hospital characteristics positively associated with ACA services included higher county population density, per capita income, and physician availability.
- The presence of psychiatric services and personnel was a key correlate, with scarcity of psychiatric staff identified as a major barrier.
Conclusions:
- Rural hospital-sponsored alcohol and chemical abuse (ACA) services are infrequent, potentially failing to meet population needs.
- The availability of psychiatric services and personnel is critical for establishing and sustaining ACA services in rural areas.
- Non-hospital-based services may play a role in addressing the gap in rural substance abuse treatment.