Using recidivism rates as a quality indicator for substance abuse treatment programs

Recidivism is a widely used quality indicator for inpatient substance abuse care. However, unadjusted recidivism rates do not account for important confounding variables, which may lessen their usefulness as a quality indicator. Using a study of a statewide network of inpatient substance abuse services in Connecticut, the authors present a method for sampling existing administrative data and adjusting recidivism rates. The method can be used by managers of provider networks to assess whether patient subgroups with different demographic or geographic characteristics have equal access to care; to check for potential weaknesses in services, facilities, or systems; and to identify programs with unusually high or low recidivism rates for improvement or replication.