Building Organizational Capacity to Eliminate Racial/Ethnic Health Disparities

Abstract

Using neo-institutional, leadership and readiness for change theories, we evaluated organizational capacity factors associated with client wait time and retention in addiction health services in one of the most diverse regions of the United States. Using multilevel cross-sectional analyses, we evaluated organizational data (n = 108) merged with client data (n = 13,478). Findings show that institutional, as well as readiness for change factors were associated with client outcomes. In particular, acceptance of public insurance and staff attributes related to readiness for change were associated with clients' shorter wait times. Staff attributes for change were also related to shorter treatment retention. Professional accreditation, drug court referrals, and client public insurance eligibility were associated with greater retention in treatment. Programs with greater capacity had clients with shorter wait times and greater retention across ethnic groups. Implications for health care reform in the United States and other industrialized and diverse nations are discussed.