Predictors of substance abuse treatment retention among women and men in an HMO

Background: Although prior research has examined predictors of treatment re tention in public alcohol and drug treatment programs, little is known abou t factors that influence treatment retention in an insured outpatient popul ation. Because there is growing evidence that the factors which influence t reatment retention may differ by gender, we identify sex-specific predictor s. Methods: We recruited all eligible intakes to a health maintenance organiza tion's outpatient alcohol and drug treatment program during a 2-year period and obtained a sample of 317 women and 599 men. The programs, day hospital and traditional outpatient modalities, were abstinence based. We separated our sample by sex and used least squares and logistic regression to identi fy independent predictors of length of stay and program completion, respect ively. Results: One general pattern of predictors of increased retention was share d by women and men in this alcohol and drug treatment program-fewer and les s severe drug problems. However, most predictors were sex-specific. Among w omen, retention was predicted by having higher incomes, belonging to ethnic categories other than African American, being unemployed, being married, a nd having lower levels of psychiatric severity. Among men, predictors of hi gher retention included being older, receiving employer suggestions to ente r treatment, and having abstinence goals. Conclusions: These findings highlight the importance of examining aspects o f the course of treatment separately by sex. They also suggest treatment fa ctors that may enhance retention among insured populations, including emplo yer referrals, psychiatric services, and drug-related services.