Adoption of telemedicine services by substance abuse treatment facilities in the US
Adoption of telemedicine services by substance abuse treatment facilities in the US
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DOI：
10.1016/j.jsat.2020.108060
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发表时间：
2020-10-01
影响因子：
3.9
通讯作者：
Barnett, Michael
中科院分区：
文献类型：
--
作者：
Uscher-Pines, Lori;Cantor, Jonathan;Barnett, Michael
目的：描述有执照的药物滥用治疗机构采用远程医疗的趋势，以及不同地方因素的采用情况，包括县级药物超标率、城市化措施和州政策法规。方法：我们分析了2016-2019年国家药物和酒精滥用治疗机构目录的数据。我们的主要成果是一家治疗机构使用远程医疗。我们还从其他数据集中获取了自变量，包括估计的县级药物中毒死亡人数和州级远程医疗政策。我们估计了一个多变量Logistic回归模型，以确定哪些设施特征与提供远程医疗相关。结果：从2016年到2019年，平均纳入12,334个治疗设施。在此期间，提供远程医疗的设施的未调整比例从13.5%增长到17.4%(p<；0.001)。在调整后的模型中，农村地区；提供多种治疗环境；提供药物治疗；为成人和儿童患者提供服务与更多的远程医疗采用相关(P<；0.05用于所有比较)。在物质使用障碍(SUD)治疗机构中，远程医疗的讨论性使用稳步增加；然而，吸收不均衡且相对较低。因此，远程医疗可能是一种未得到充分利用的工具，无法扩大对肥胖症患者的护理。
Objective: To describe trends in licensed substance use treatment facilities' adoption of telemedicine and how adoption varies across local factors, including county-level drug overdose rates, urbanicity measures, and state policy laws.Methods: We analyzed data (2016-2019) from the National Directory of Drug and Alcohol Abuse Treatment Facilities. Our main outcome was telemedicine use by a treatment facility. We also captured independent variables from other datasets, including estimated county-level drug poisoning deaths and state-level telemedicine policies. We estimated a multivariable logistic regression model to determine which facility characteristics were associated with offering telemedicine.Results: From 2016 to 2019, an average of 12,334 treatment facilities were included. During this period, the unadjusted proportion of facilities offering telemedicine grew from 13.5% to 17.4% (p < 0.001). In adjusted models, rural location; offering multiple treatment settings; offering pharmacotherapy; and serving both adult and pediatric patients were associated with greater telemedicine adoption (p < 0.05 for all comparisons).Discussion Use of telemedicine is increasing steadily among substance use disorder (SUD) treatment facilities; however, uptake is uneven and relatively low. As such, telemedicine may be an underutilized tool to expand access to care for patients with SUDs.