Appointment wait-times and arrival for patients at a low-barrier access addiction clinic
Appointment wait-times and arrival for patients at a low-barrier access addiction clinic
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DOI：
10.1016/j.jsat.2020.108011
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发表时间：
2020-07-01
影响因子：
3.9
通讯作者：
Walley, Alexander Yale
中科院分区：
文献类型：
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作者：
Roy, Payel Jhoom;Choi, Sugy;Walley, Alexander Yale
简介：酒精和阿片类药物使用障碍的成瘾治疗（MAT）当天或次日获得门诊药物可能有助于物质使用障碍（SUD）循证疗法的持续治疗。本研究评估了预约等待时间和到达预约的患者寻求门诊MAT.Methods的几率之间的关联：研究样本包括患者谁安排了2016年8月1日和2017年7月31日之间的预约与低障碍访问成瘾诊所。感兴趣的结果是约会的状态作为二分变量：到达或没有出现/取消。主要自变量（等待时间）是患者安排门诊预约日期与服务日期之间的过夜次数，分为0天、1天和2天以上。我们进行了双变量和多变量logistic回归，计算未调整和调整的比值比到达。多变量分析进行了调整，性别，年龄，从诊所居住的距离，和保险type.Results：我们的分析包括657例患者，其中410（62%）到达他们的第一次预约。在657例患者中，47%（308例）在同一天（0天）安排就诊，其中82%（252例）就诊，23%（151例）等待1天（次日），其中53%（80例）就诊，30%（198例）等待2天以上，其中39%（78例）就诊。患者更有可能在同一天被看到，（OR 6.9 [95% CI 4.6-10.4]; AOR 7.5 [4.9-11.4]）或次日（OR 1.7 [1.1-2.7]; AOR 1.7 [1.1-2.6]）预约与等待2天以上相比。通过安排当天和第二天预约治疗的诊所寻求MAT的患者与等待更长时间的患者相比，更有可能参加成瘾预约。诊所应努力减少寻求MAT的患者的等待时间。
Introduction: Same-day or next-day access to outpatient medication for addiction treatment (MAT) for both alcohol and opioid use disorders may facilitate sustained treatment with evidence-based therapies for substance use disorders (SUD). This study evaluates the association between appointment wait-times and odds of arrival to appointment for patients seeking outpatient MAT.Methods: The study sample consisted of patients who scheduled an appointment with a low-barrier access addiction clinic between August 1, 2016, and July 31, 2017. The outcome of interest was the status of the appointment as a dichotomous variable: arrive or no-show/cancel. The primary independent variable (wait-time) was the number of overnights between the date a patient scheduled a clinic appointment and the date of service, categorized as 0 days, 1 day, and 2+ days. We conducted bivariable and multivariable logistic regressions to calculate unadjusted and adjusted odds ratios for arrival. Multivariable analyses were adjusted for gender, age, distance of residence from the clinic, and insurance type.Results: Our analysis included 657 patients, of whom 410 (62%) arrived to their first appointment. Among the 657 patients, 47% (308) were scheduled the same day (0 days) and 82% (252) of them were seen, 23% (151) waited 1 day (next-day) and 53% (80) of them were seen, and 30% (198) waited 2 + days and 39% (78) of them were seen. Patients were more likely to be seen when they had a same-day (OR 6.9 [95% CI 4.6-10.4]; AOR 7.5 [4.9-11.4]) or next-day (OR 1.7 [1.1-2.7]; AOR 1.7 [1.1-2.6]) appointment compared to waiting 2+ days.Conclusion: Patients seeking MAT through a clinic that schedules same-day and next-day appointments for treatment are more likely to attend addiction appointments compared to patients who wait longer. Clinics should strive to reduce wait-times for patients seeking MAT.