How Is Telemedicine Being Used In Opioid And Other Substance Use Disorder Treatment?
How Is Telemedicine Being Used In Opioid And Other Substance Use Disorder Treatment?
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DOI：
10.1377/hlthaff.2018.05134
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发表时间：
2018-12-01
期刊：
影响因子：
9.7
通讯作者：
Mehrotra, Ateev
中科院分区：
文献类型：
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作者：
Huskamp, Haiden A.;Busch, Alisa B.;Mehrotra, Ateev
只有一小部分患有物质使用障碍（SUD）的人接受治疗。特别是在农村地区，单一用途药物治疗提供者的短缺是造成这种治疗差距的一个重要因素。远程医疗可以成为扩大获得治疗机会的一种手段。然而，存在几个关键的监管和报销障碍，以更多地使用远程医疗的SUD（远程SUD），国会和各州正在考虑或最近通过立法来解决这些问题。为了告知这些努力，我们描述了如何使用tele-SUD。我们使用一家大型商业保险公司2010- 2017年的索赔数据，确定了远程SUD用户的特征，并研究了远程SUD如何与现场SUD护理结合使用。尽管在研究期间，远程SUD的使用率迅速增加，但我们发现整体使用率较低，特别是相对于远程健康的增长。Tele-SUD主要用于补充现场护理，并且被相对严重的SUD患者不成比例地使用。鉴于阿片类药物流行的严重性，远程SUD使用率低意味着错过了机会。随着tele-SUD变得更加可用，密切监控正在使用的tele-SUD交付模式及其对访问和结果的影响将非常重要。
Only a small proportion of people with a substance use disorder (SUD) receive treatment. The shortage of SUD treatment providers, particularly in rural areas, is an important driver of this treatment gap. Telemedicine could be a means of expanding access to treatment. However, several key regulatory and reimbursement barriers to greater use of telemedicine for SUD (tele-SUD) exist, and both Congress and the states are considering or have recently passed legislation to address them. To inform these efforts, we describe how tele-SUD is being used. Using claims data for 2010-17 from a large commercial insurer, we identified characteristics of tele-SUD users and examined how tele-SUD is being used in conjunction with in-person SUD care. Despite a rapid increase in tele-SUD over the study period, we found low use rates overall, particularly relative to the growth in telemental health. Tele-SUD is primarily used to complement in-person care and is disproportionately used by those with relatively severe SUD. Given the severity of the opioid epidemic, low rates of tele-SUD use represent a missed opportunity. As tele-SUD becomes more available, it will be important to monitor closely which tele-SUD delivery models are being used and their impact on access and outcomes.