Patterns in admission delays to outpatient methadone treatment in the United States.
Patterns in admission delays to outpatient methadone treatment in the United States.
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DOI：
10.1016/j.jsat.2011.06.005
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发表时间：
2011-12
影响因子：
3.9
通讯作者：
Jaffe JH
中科院分区：
文献类型：
--
作者：
Gryczynski J;Schwartz RP;Salkever DS;Mitchell SG;Jaffe JH
美沙酮治疗的等候名单在美国许多社区都存在，但全国范围内对哪些患者和服务系统因素与因方案能力不足而导致的入院延迟有关知之甚少。使用国家数据源的组合，本研究探讨了在40个美国大都市地区（n= 28，920）的门诊美沙酮治疗的能力相关的入院延迟模式。与入院延迟相关的患者特征包括种族/少数民族地位、教育程度较低、刑事司法转诊、既往治疗经验、继发性可卡因或酒精使用以及同时发生的精神问题。注射毒品使用者经历了更少的延误，自费患者和医疗保健和成瘾治疗提供者的转诊也是如此。较高的社区一级美沙酮治疗的利用率与延迟有关，而延迟在替代方式利用率较高的社区不太常见。这些发现突出了及时接受美沙酮门诊治疗的潜在差异。改善治疗和服务系统监测的影响进行了讨论。
Waiting lists for methadone treatment have existed in many U.S. communities, but little is known nationally about what patient and service system factors are related to admission delays that stem from program capacity shortfalls. Using a combination of national data sources, this study examined patterns in capacity-related admission delays to outpatient methadone treatment in 40 U.S. metropolitan areas (n=28,920). Patient characteristics associated with admission delays included racial/ethnic minority status, lower education, criminal justice referral, prior treatment experience, secondary cocaine or alcohol use, and co-occurring psychiatric problems. Injection drug users experienced fewer delays, as did self-pay patients and referrals from healthcare and addiction treatment providers. Higher community-level utilization of methadone treatment was associated with delay, whereas delays were less common in communities with higher utilization of alternative modalities. These findings highlight potential disparities in timely admission to outpatient methadone treatment. Implications for improving treatment access and service system monitoring are discussed.
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