{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:20:46Z","timestamp":1791379246730,"version":"4.3.2"},"reference-count":59,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:00:00Z","timestamp":1521849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T00:00:00Z","timestamp":1521849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine retrospectively patient and programmatic outcomes following the development and implementation of an \u2018open\u2010access\u2019 model in which prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real\u2010time access to multiple voluntary treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Medical and administrative records were abstracted to compare data for 1\u00a0year before and 9\u00a0years after initiating the implementation of an open\u2010access treatment model in May 2007.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Methadone maintenance treatment center in Connecticut, USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Individuals with opioid use disorder entering treatment between July 2006 and June 2015. In June 2015, 64% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a02594) of the sample were men and 80% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a03133) reported that they were white.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>The Network for the Improvement of Addiction Treatment\u2010informed open\u2010access treatment model uses process improvement strategies to improve treatment access and capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Census, waiting time, retention, non\u2010medical opioid use, patient mortality and financial sustainability (net income and state\u2010block grants as proportions of revenue).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>In the 9\u00a0years following the initial implementation of the open\u2010access model, patient census increased by 183% from 1431 to 4051, and average waiting\u2010time days decreased from 21 to 0.3 (same day) without apparent deleterious effects on rates of retention, non\u2010medical opioid use or mortality. Between fiscal years (FY) 06 and FY 15, net operating margin rose from 2 to 10%, while state\u2010block grant revenues declined 14% and the proportion of total revenue from state\u2010block grant revenue decreased from 49 to 24%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An open\u2010access model for rapid enrolment of people with opioid use disorder in methadone treatment appears to improve treatment access, capacity, and financial sustainability without evidence of deleterious effects on treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.14198","type":"journal-article","created":{"date-parts":[[2018,2,17]],"date-time":"2018-02-17T10:02:43Z","timestamp":1518861763000},"page":"1450-1458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["An investigation of an open\u2010access model for scaling up methadone maintenance treatment"],"prefix":"10.1111","volume":"113","author":[{"given":"Lynn M.","family":"Madden","sequence":"first","affiliation":[{"name":"Yale University School of Medicine  New Haven CT USA"},{"name":"The APT Foundation, Inc.  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