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Organizational capacity to eliminate outcome disparities in addiction health services


Identifying provider characteristics associated with greater capacity to implement new practices geared toward reducing the disparities gap in health-care services has become a chief priority. Yet, there is limited information on conceptual frameworks and methodologies to understand key organizational factors associated with positive client outcomes.


To evaluate program capacity factors associated with client outcomes in publicly funded substance abuse treatment in one of the most populous and diverse regions of the United States.


Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010 to 2011 for adults (n = 8599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and retention in treatment.


Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Finally, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration.


Program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for reducing disparities under the current health-care reform context are discussed.


This study was funded by the National Institute on Drug Abuse (R21DA035634-01).

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Correspondence to Erick G Guerrero.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Guerrero, E.G., Aarons, G., Grella, C. et al. Organizational capacity to eliminate outcome disparities in addiction health services. Addict Sci Clin Pract 10 (Suppl 1), A19 (2015).

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