Chapter 3

Trends in Client Characteristics

This chapter presents trends in client characteristics for 1998 to 2004. It should be kept in mind, however, that the facility universe, methods, and survey instrument have changed during this period. These changes are detailed in Appendix C.

Table 3.1. The number of clients in treatment on the survey reference date increased by 3 percent between 1998 and 2004, from 1,038,378 in 1998 to 1,072,251 in 2004.

Table 3.1 and Figure 5. The proportion of clients in facilities operated by private non-profit organizations changed little between 1998 and 2004, increasing from 556,191 clients (54 percent of all clients) in 1998 to 588,170 clients (55 percent of all clients) on March 31, 2004. The number of clients in private for-profit facilities increased from 252,369 (24 percent of all clients) in 1998 to 296,533 (28 percent of all clients) on March 31, 2004. The proportions of clients in government-operated facilities generally fell between 1998 and 2004 —from 11 percent to 9 percent for local government-operated facilities; from 6 percent to 4 percent for State government-operated facilities, and from 4 percent to 3 percent for Federal government-operated facilities. The proportion of clients in tribal government-operated facilities remained constant, at 1 percent.

Table 3.2 and Figure 6. The proportions of clients in treatment for the major types of care—outpatient, non-hospital residential, and hospital inpatient—remained relatively stable between 1998 and 2004. There were 954,551 clients (89 percent of all clients) in outpatient treatment on March 31, 2004, compared to 915,798 (88 percent of all clients) in 1998. There were 101,713 clients (9 percent of all clients) in non-hospital residential treatment on March 31, 2004, compared to 107,961 (10 percent of all clients) in 1998. There were 15,987 clients (1 percent of all clients) in hospital inpatient treatment on March 31, 2004, compared to 14,619 (1 percent of all clients) in 1998.
 

Clients Receiving Methadone

Table 3.2 and Figure 6. The number and proportion of clients receiving methadone increased from 145,610 (14 percent of all clients) in 1998 to 240,961 clients (22 percent of all clients) in 2004. Clients receiving methadone could be in any of the three major types of care—outpatient, non-hospital residential, and hospital inpatient.

Table 3.3. The proportion of clients in treatment for both drug and alcohol abuse decreased from 49 percent in 1998 to 46 percent in 2004. The proportion of clients treated for drug abuse only increased from 27 percent in 1998 to 34 percent in 2004. The proportion of clients treated for alcohol abuse only declined from 24 percent in 1998 to 20 percent in 2004.

Table 3.4 and Figure 7. In general, the term "managed care" refers to the prepaid health care sector where care is provided under a fixed budget within which costs are "managed." The trends in the proportion of clients in facilities with agreements or contracts with managed care organizations were grossly similar to those for the proportion of facilities with such agreements or contracts [Table 2.4]. On March 31, 2004, 50 percent of all clients were in facilities with managed care agreements or contracts, and 49 percent of facilities had such agreements or contracts. This represented an increase from 1998, when 46 percent of all clients were in facilities with managed care agreements or contracts, and 44 percent of facilities had such agreements or contracts. The percentage of clients in facilities with managed care agreements or contracts increased between 1998 and 2000 for all facility operation categories. Between 2000 and 2004, however, the proportion of clients in facilities with managed care agreements or contracts generally declined slightly.
 

Clients under Age 18 in Treatment

Table 3.5 and Figure 8. On March 31, 2004, there were 91,112 clients under age 18 in treatment. These represented 8 percent of all clients. Clients under age 18 made up 10 percent of all clients in 1998, but the proportion fell to 8 percent in 2000 and remained stable through 2004.

The majority of clients under age 18 were in treatment facilities with special programs or groups for adolescents. On March 31, 2004, 75,878 clients under age 18 (83 percent of all clients under age 18) were in treatment facilities with special programs or groups for adolescents. The proportion of clients under age 18 in facilities with special programs or groups for adolescents fluctuated between 1998 and 2004, from a low of 80 percent in 1998 to a high of 91 percent in 2002.