Shortages of Medication-Assisted Treatment for Opioid Use Disorder in Underserved Michigan Counties: Examining the Influence of Urbanicity and Income Level
Shortages of Medication-Assisted Treatment for Opioid Use Disorder in Underserved Michigan Counties: Examining the Influence of Urbanicity and Income Level
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DOI：
10.1353/hpu.2020.0095
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发表时间：
2020-08-01
影响因子：
1.4
通讯作者：
Himle, Joseph A.
中科院分区：
文献类型：
--
作者：
Lister, Jamey J.;Weaver, Addie;Himle, Joseph A.
过量死亡率继续上升，需要获得药物辅助治疗（MAT）。然而，国家数据显示农村短缺。该研究的目的是调查中西部的农村/城市比较，同时检查农村和低收入状况的影响。我们提取了密歇根州83个县的2018年公共数据，包括两种MAT表格：1）美沙酮诊所和2）豁免丁丙诺啡从业者。城市化是使用农村城市连续代码操作。收入是根据美国人口普查数据分类的。双变量分析表明，农村（ps < .001）和低收入县（ps < .01）的MAT短缺。在多变量分析中，城市县拥有诊所（p < .001）或从业人员（p < .05）的可能性分别是农村县的35.6倍和12.2倍。高收入县有从业者的可能性是低收入县的5.9倍（p < .01）。这些州一级的调查结果确定了目前服务不足的密歇根州县。迫切需要采用经济办法，将治疗扩大到服务不足的社区。
Overdose-death rates continue to rise, necessitating accessible medication-assisted treatment (MAT). However, national data demonstrate rural shortages. The purpose of the study was to investigate rural/urban comparisons in the Midwest and simultaneously examine the influence of rural and low-income status. We extracted 2018 public data for Michigan's 83 counties on two MAT forms: 1) methadone clinics and 2) waivered buprenorphine practitioners. Urbanicity was operationalized using Rural Urban Continuum Codes. Income was categorized with U.S. Census data. Bivariate analyses demonstrated MAT shortages among rural (ps < .001) and low-income counties (ps < .01). In multivariable analyses, urban counties were 35.6 and 12.2 times more likely than rural counties to have any clinic(s) (p < .001) or practitioner(s) (p < .05), respectively. High-income counties were 5.9 times more likely than low-income counties to have any practitioner(s) (p < .01). These state-level findings identify targeted Michigan counties currently underserved for available MAT. Expanding treatment access to underserved communities using economic approaches is urgently needed.