Disparities in Access to Physicians and Medications for the Treatment of Substance Use Disorders Between Publicly and Privately Funded Treatment Programs in the United States
Disparities in Access to Physicians and Medications for the Treatment of Substance Use Disorders Between Publicly and Privately Funded Treatment Programs in the United States
复制标题
DOI：
10.15288/jsad.2013.74.258
复制
发表时间：
2013-03-01
影响因子：
3.4
通讯作者：
Roman, Paul M.
中科院分区：
文献类型：
--
作者：
Abraham, Amanda J.;Knudsen, Hannah K.;Roman, Paul M.
目的：先前的研究表明，公共资助的物质使用障碍（SUD）治疗计划在采用循证实践方面落后于私人资助的计划，导致获得高质量SUD治疗的差异。这些差异突出了一个关键的公共卫生问题，因为大多数SUD患者在美国接受治疗的公共资助的治疗部门。本研究使用最近的数据，以检查在获得医生和药物治疗SUD之间的公共和私人资助的SUD治疗计划的可用性的差异。方法：从2007年到2010年，通过面对面访谈、邮寄调查和与治疗项目管理人员的电话访谈，收集了595个专业SUD治疗项目的数据。结果如下：公共资助的项目不太可能比私人资助的项目有一个医生的工作人员，即使在控制了几个组织特征，与医生的访问。负二项回归的结果表明，即使考虑到医生的访问和其他组织变量，公共资助的程序规定更少的SUD药物比私人资助的SUD治疗方案。结论：在公共资助的治疗项目中寻求治疗的患者在获得高质量SUD治疗方面继续面临差异，该治疗支持患者在一系列药物选择中进行选择。然而，《平价医疗法案》的实施可能有助于更多地获得医生的帮助，并在公共资助的SUD治疗计划中使用药物。(J.酒精药物研究，74，258-265，2013）
Objective: Prior research suggests that publicly funded substance use disorder (SUD) treatment programs lag behind privately funded programs in adoption of evidence-based practices, resulting in disparities in access to high-quality SUD treatment. These disparities highlight a critical public health concern because the majority of SUD patients in the United States are treated in the publicly funded treatment sector. This study uses recent data to examine disparities in access to physicians and availability of medications for the treatment of SUDs between publicly and privately funded SUD treatment programs. Method: Data were collected from 595 specialty SUD treatment programs from 2007 to 2010 via face-to-face interviews, mailed surveys, and telephone interviews with treatment program administrators. Results: Publicly funded programs were less likely than privately funded programs to have a physician on staff, even after controlling for several organizational characteristics that were associated with access to physicians. The results of negative binomial regression indicated that, even after taking into account physician access and other organizational variables, publicly funded programs prescribed fewer SUD medications than privately funded SUD treatment programs. Conclusions: Patients seeking treatment in publicly funded treatment programs continue to face disparities in access to high-quality SUD treatment that supports patients' choices among a range of medication options. However, implementation of the Affordable Care Act may facilitate greater access to physicians and use of medications in publicly funded SUD treatment programs. (J. Stud. Alcohol Drugs, 74, 258-265, 2013)