Health Services Management Research > Volume 21, Number 3 > Pp. 168-177

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Organizational determinants of boundary spanning activity in outpatient substance abuse treatment programmes

Jeffrey A Alexander ^* , Rebecca Wells , Lan Jiang  and Harold Pollack 

* Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI; School of Public Health, University of North Carolina, Health Policy and Administration, Chapel Hill, NC; Targeted Research Enhancement Program, HSR&D, Providence VA Medical Center, Providence, RI; School of Social Service, University of Chicago, Chicago, IL, USA

Correspondence to: Jeffrey A Alexander Email: jalexand{at}umich.edu

Objectives: Substance abuse treatment programmes depend on boundary spanning to identify opportunities and threats, and represent their interests to stakeholders such as licensing entities and regulators. This study sought to identify director, client, unit and market factors associated with active director boundary spanning.

Methods: Using data from the 1995, 1999–2000 and 2005 waves of a national survey of outpatient substance abuse treatment units, generalized estimating equation regression models tested associations between predictors and five aspects of directors' self-reported boundary spanning.

Results: Directors licensed as substance abuse treatment counsellors spent more time than average consulting with other treatment providers and making presentations in the community. Older directors spent less time consulting with other treatment providers, making community presentations and liaisoning with monitoring organizations. The few associations between client unemployment and director boundary spanning were positive; the two associations between the percentage of clients who were African-American and boundary spanning were negative. Private ownership and being based in larger organizations were negatively associated with some types of boundary spanning. Perceived competition for public support was positively associated with all measures of boundary spanning.

Conclusion: Directors of treatment organizations may improve treatment practices and political leverage by directly, but selectively, interacting with key external stakeholders.

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