Use of Primary Care and Emergency Departments for Substance Use Treatment: The Rural and Urban Divide.
Use of Primary Care and Emergency Departments for Substance Use Treatment: The Rural and Urban Divide.
复制标题
利用初级保健和急诊部门进行药物滥用治疗：农村和城市的差距。
DOI：
10.1080/10826084.2023.2269581
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发表时间：
2024
影响因子：
2
通讯作者：
Morgan,Ethan
中科院分区：
文献类型：
--
作者：
Albright,Nathaniel;Dyar,Christina;Morgan,Ethan
背景：酒精和非法物质的使用在美国仍然是严重的公共卫生问题。在这项分析中，我们评估了农村和城市性少数群体在使用初级保健和急诊科治疗药物使用方面的差异。方法：数据来自全国药物使用与健康调查(NSDUH，2015-2019年)。使用调查加权多变量线性和Logistic回归分析，评估性别认同与使用初级保健环境或急救药物治疗的关系。结果：在整个样本中，7.9%的人报告居住在农村环境，城市(7.3%)比农村(5.4%)的居住环境略多一些。农村(β=-0.20；95%CI：−0.29，−0.10)和城市短信(β=-0.13；95%CI：−0.16，−0.11)自我报告的总体健康状况较差。城市短信，而不是农村短信，报告因药物使用而使用初级保健治疗的几率显著更高(AOR 2.80；95%CI：2.13，3.68)。农村(AOR=2.99；95%CI：1.0 1，8.87)和城市(AOR=3.0 2；95%CI：2.12，4.30)以及农村(β = 0.48；95%CI：0.2 4，0.72)和城市短信(β = 0.2 3；95%CI：0.19，0.2 8)的ED就诊次数均高于农村(AOR=2.99；95%CI：1.0 1，8.87)。未来的研究应该检查增加农村地区有文化能力的初级保健服务是否可能是减少健康差距的关键干预点。
Background: Alcohol and illicit substance use remain significant public health issues in the United States. In this analysis, we assessed differences in the use of primary care and emergency departments (EDs) for treatment of substance use among rural and urban sexual minorities (SMs).Methods: Data come from the National Survey on Drug Use and Health (NSDUH, 2015-2019). Survey-weighted multivariable linear and logistic regression analyses were used to assess the relationship between sexual identity and the use of primary care settings or EDs for treatment of substance use, stratified by urbanicity of residence.Results: Among the entire sample, 7.9% reported residing in rural environments with slightly more SMs living in urban (7.3%) relative to rural (5.4%) locales. Both rural (β=-0.20; 95% CI: −0.29, −0.10) and urban SMs (β=-0.13; 95% CI: −0.16, −0.11) self-reported worse overall health. Urban SMs, but not rural SMs, had significantly higher odds of reporting use of primary care treatment for substance use (aOR 2.80; 95% CI: 2.13, 3.68). ED treatment for substance use was greater among both rural (aOR = 2.99; 95% CI: 1.01, 8.87) and urban SMs (aOR = 3.02; 95% CI: 2.12, 4.30) as was overall number of ED visits among both rural (β = 0.48; 95% CI: 0.24, 0.72) and urban SMs (β = 0.23; 95% CI: 0.19, 0.28) .Conclusion: These findings suggest increased reliance on EDs for treatment of alcohol or substance use among rural SMs. Future research should examine whether increasing culturally competent primary care services for SMs in rural areas may be a key intervention point for reducing health disparities.