Spillover of Medicaid Expansion to Prescribing of Opioid Use Disorder Medications in Medicare Part D
Spillover of Medicaid Expansion to Prescribing of Opioid Use Disorder Medications in Medicare Part D
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DOI：
10.1176/appi.ps.202000824
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发表时间：
2022-04-01
影响因子：
3.8
通讯作者：
Bradford, W. David
中科院分区：
文献类型：
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作者：
Abraham, Amanda J.;Lawler, Emily C.;Bradford, W. David
目的：作者研究了在医疗补助扩张州，阿片类药物使用障碍药物处方对医疗保险D部分受益人是否存在积极的溢出效应。尽管之前的研究表明，医疗补助计划的扩张对阿片类药物使用障碍的美国人有几个积极的好处，但研究并没有研究对受到阿片类药物危机严重打击的医疗保险受益人的潜在溢出效应。方法：处方数据取自医疗保险D部分处方公共使用文件（2010-2017）。一个差异中的差异线性回归框架被用来确定丁丙诺啡和注射纳曲酮处方给医疗补助扩张州的医疗保险D部分受益人的溢出效应。三组因变量测量了县一级的药物处方（N=24,850）。所有模型都包括县和年份固定效应，标准误差集中在州一级，以解决州内的序列相关性。结果：医疗补助扩大与一个县拥有注射纳曲酮提供者的可能性增加有关(p
Objective: The authors examined whether there were positive spillovers in opioid use disorder medication prescribing to Medicare Part D beneficiaries in Medicaid expansion states. Although prior studies have shown several positive benefits of Medicaid expansion for Americans with opioid use disorder, research has not examined potential spillovers to Medicare beneficiaries who have been hit hard by the opioid crisis.Methods: Prescribing data were taken from the Medicare Part D Prescription Public Use File (2010-2017). A difference-in-differences linear regression framework was used to identify spillovers in prescribing of buprenorphine and injectable naltrexone to Medicare Part D beneficiaries in Medicaid expansion states. Three sets of dependent variables measured medication prescribing at the countyyear level (N=24,850). All models included county and year fixed effects, with standard errors clustered at the state level to address within-state serial correlation.Results: Medicaid expansion was associated with an increase in the probability of a county having an injectable naltrexone provider (p