Post-Discharge Treatment Engagement Among Patients with an Opioid-Use Disorder
Post-Discharge Treatment Engagement Among Patients with an Opioid-Use Disorder
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DOI：
10.1016/j.jsat.2016.07.004
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发表时间：
2016-10-01
影响因子：
3.9
通讯作者：
Hughey, Lauren
中科院分区：
文献类型：
--
作者：
Naeger, Sarah;Mutter, Ryan;Hughey, Lauren
简介：阿片类药物滥用是一个日益严重的公共卫生问题，据估计，在过去二十年中，与阿片类药物相关的住院时间增加了 150%。本研究调查了因阿片类药物使用障碍或过量住院后与物质使用治疗参与度相关的因素。方法：本研究分析了 Truven Health Analytics MarketScane 商业索赔和遭遇 (CCAE) 数据库 2010 年至 2014 年的数据，以研究因阿片类药物使用障碍或阿片类药物过量住院的 18-64 岁个体的住院后药物使用障碍 (SUD) 治疗。参与出院后 SUD 治疗的定义是在住院后 30 天内至少进行过两次独特的门诊就诊。使用二项式关联的广义估计方程 (GEES) 来确定与 SUD 治疗参与相关的因素。结果：只有 17% 的患者在出院 30 天内接受 SUD 治疗。在 SUD 入院之前进行行为健康门诊就诊会增加这种可能性。参与 SUD 治疗的几率增加 1.34 (CI: 125-1.45)，SUD 入院前服用抗抑郁处方药会使几率增加 1.14 (CI: 1.07-1.21)，SUD 入院前服用苯二氮卓类药物会使几率增加 1.14 (CI: 1.07-1.21)，入院时主要诊断为 SUD 会使几率增加2.13 (CI: 1.97-2.30)，首次入院时酒精相关疾病诊断使几率增加 3.13 (CI: 2.87-3.42)，初次入院时额外 SUD 诊断使几率增加 2.72 (CI: 2.48-2.98)。结论：我们发现因阿片类药物使用障碍和过量住院后 SUD 治疗参与率较低。之前与行为健康提供者接触过的患者更有可能接受后续护理；因此，医疗服务提供者可能需要将额外的精力集中在因阿片类药物使用障碍入院但没有现有医疗服务提供者关系的患者身上。由爱思唯尔公司出版
Introduction: Opioid misuse is a growing public health problem, and estimates show a 150% increase in opioid-related hospital stays over the last two decades. This study examined factors associated with substance use treatment engagement following a hospitalization for opioid use disorder or overdose.Methods: This study analyzed the Truven Health Analytics MarketScane Commercial Claims and Encounters (CCAE) database for 2010 through 2014 to study post-hospitalization substance use disorder (SUD) treatment of individuals aged 18-64 who had an inpatient admission for an opioid-use disorder or opioid overdose. Engagement in post-discharge SUD treatment was defined as having at least two unique outpatient visits within 30 days of a hospitalization. Generalized estimating equations (GEES) with a binomial link were used to determine the factors associated with SUD treatment engagement.Results: Only 17% of patients engaged in SUD treatment within 30 days of hospital discharge. A behavioral health outpatient visit prior to the SUD admission increased the odds. of engaging in SUD treatment by 1.34 (Cl: 125-1.45), an antidepressant prescription drug fill prior to the SUD admission increased the odds by 1.14 (CI: 1.07-1.21), a benzodiazepine fill prior to the SUD admission increased the odds by 1.14 (CI: 1.07-1.21), a principal diagnosis for an SUD at index admission increased the odds by 2.13 (CI: 1.97-2.30), an alcohol related disorder diagnosis at index admission increased the odds by 3.13 (CI: 2.87-3.42), and an additional SUD diagnosis at the index admission increased the odds by 2.72 (CI: 2.48-2.98).Conclusions: We found low rates of SUD treatment engagement following hospitalizations for opioid use disorders and overdoses. Patients with prior engagements with behavioral health providers were more likely to engage in follow-up care; therefore, providers may need to focus additional efforts on patients admitted to the hospital with opioid-use disorders who do not have an existing provider relationship. Published by Elsevier Inc.