Chapter 1

Description of the Treatment Episode Data Set (TEDS)

Introduction

History

TEDS in the Context of DASIS

Limitations of TEDS

Interpretation of the Data

[Main Table of Contents]


Introduction

This report presents results from the Treatment Episode Data Set (TEDS) for 2000, and trend data for 1992-2000. The report provides information on the demographic and substance abuse characteristics of the approximately 1.6 million annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual State administrative data systems. The Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA), coordinates and manages collection of TEDS data from the States.

The TEDS system is comprised of two major components, the Admissions Data System and the Discharge Data System. The TEDS Admissions Data System is an established program that has been operational for over 10 years. It includes data on treatment admissions that are routinely collected by States to monitor their individual substance abuse treatment systems. The TEDS Discharge Data System is relatively new. For both data systems, selected data items from the individual State data files are converted to a standardized format consistent across States. These standardized data constitute TEDS.

The TEDS Admissions Data System consists of a Minimum Data Set collected by all States, and a Supplemental Data Set collected by some States. The Minimum Data Set consists of 19 items that include:

The Supplemental Data Set includes 15 items that include psychiatric, social, and economic measures.

The TEDS Discharge Data System was designed to enable TEDS to collect information on entire treatment episodes. Discharge data, when linked to admissions data, represent treatment episodes that enable analyses of questions that cannot be answered with admissions data alone. Currently about 20 States are submitting discharge data or are actively preparing to submit data. Enlistment of States into the system is ongoing, with participation by all States that collect discharge data expected by the end of 2003.

Definitions and classifications used in the Admissions Minimum and Supplemental Data Sets and the Discharge Data Set are detailed in the Appendix.

History

National-level data collection on admissions to substance abuse treatment was first mandated in 1972 under the Drug Abuse Office and Treatment Act, P.L. 92-255. This act initiated Federal funding for drug treatment and rehabilitation, and required reporting on clients entering drug (but not alcohol) abuse treatment. The Client-Oriented Data Acquisition Process (CODAP) was developed to collect admission and discharge data directly from Federally-funded drug treatment programs. (Programs for treatment of alcohol abuse were not included.) Reporting was mandatory for all such programs, and data were collected using a standard form. CODAP included all clients in federally funded programs regardless of individual funding source. Reports were issued from 1973-1981 based on data from 1,800-2,000 programs, including some 200,000 annual admissions.

In 1981, collection of national-level data on admissions to substance abuse treatment was discontinued because of the introduction of the Alcohol, Drug Abuse, and Mental Health Services (ADMS) Block Grant. The Block Grant transferred Federal funding from individual programs to the States for distribution, and included no data reporting requirement. Participation in CODAP became voluntary; although several States submitted data through 1984, the data were in no way nationally representative.

In 1988, the Comprehensive Alcohol Abuse, Drug Abuse, and Mental Health Amendments (P.L. 100-690) established a revised Substance Abuse Prevention and Treatment (SAPT) Block Grant and mandated Federal data collection on clients receiving treatment for either alcohol or drug abuse. The Treatment Episode Data Set (TEDS) data collection effort represents the Federal response to this mandate. TEDS began in 1989 with the issue of 3-year development grants to States.

TEDS in the Context of DASIS

TEDS is one of the three components of SAMHSA’s Drug and Alcohol Services Information System (DASIS). DASIS is the primary source of national data on substance abuse treatment. The core component of DASIS is the Inventory of Substance Abuse Treatment Services (I-SATS), a continuously-updated comprehensive listing of all known public and private substance abuse treatment facilities. The third component of DASIS is the National Survey of Substance Abuse Treatment Services (N-SSATS), an annual survey of the location, characteristics, services offered, and utilization of alcohol and drug abuse treatment facilities in I-SATS. A unique ID number assigned to each I-SATS facility is used in the collection of client-level data (TEDS) and facility-level data (N-SSATS). Together, they provide national- and State-level information on the numbers and characteristics of individuals admitted to alcohol and drug treatment and describe the facilities that deliver care to those individuals.

TEDS includes facilities that are licensed or certified by the State substance abuse agency to provide substance abuse treatment (or are administratively tracked for other reasons), and that are required by the States to provide TEDS client-level data.

Limitations of TEDS

TEDS, while comprising a significant proportion of all admissions to substance abuse treatment, does not include all such admissions. TEDS is a compilation of facility data from State administrative systems. The scope of facilities included in TEDS is affected by differences in State licensure, certification, accreditation, and disbursement of public funds. For example, some State substance abuse agencies regulate private facilities and individual practitioners, while others do not. In some States, hospital-based substance abuse treatment facilities are not licensed through the State substance abuse agency. Some State substance abuse agencies track correctional facilities (State prisons and local jails), while others do not.

In general, facilities reporting TEDS data receive State alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of alcohol and/or drug treatment services (see Chapter 4). Most States are able to report all admissions to all eligible facilities, although some report only admissions financed by public funds. States may report data from facilities that do not receive public funds, but generally do not because of the difficulty in obtaining data from these facilities. TEDS generally does not include data on facilities operated by Federal agencies, including the Bureau of Prisons, the Department of Defense, and the Department of Veterans Affairs. However, some facilities operated by the Indian Health Service are included.

The primary goal of TEDS is to monitor the characteristics of treatment episodes for substance abusers. Implicit in the concept of treatment is a planned, continuing treatment regimen. Thus TEDS does not include early intervention programs that are considered to be prevention programs. Crisis intervention facilities such as sobering-up stations and hospital emergency departments generally are not included in TEDS, although a State may opt to include such programs in its submissions to TEDS.

Interpretation of the Data

TEDS is an exceptionally large and powerful data set. Like all data sets, however, care must be taken that interpretation does not extend beyond the limitations of the data. Limitations fall into two broad categories: those related to the scope of the data collection system, and those related to the difficulties of aggregating data from highly diverse State data collection systems.

Limitations to be kept in mind while analyzing TEDS admissions data include:

Considerations specific to this report include:

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