Do benefits restrictions limit Medicaid acceptance in addiction treatment? Results from a national study
Do benefits restrictions limit Medicaid acceptance in addiction treatment? Results from a national study
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DOI：
10.1016/j.jsat.2018.01.010
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发表时间：
2018-04-01
影响因子：
3.9
通讯作者：
Friedmann, Peter D.
中科院分区：
文献类型：
--
作者：
Andrews, Christina M.;Grogan, Colleen M.;Friedmann, Peter D.
目的：评估成瘾治疗的医疗补助福利限制与成瘾治疗计划中医疗补助接受程度的关系。数据来源：我们收集了2013-2014年国家药物滥用治疗系统调查的主要数据。研究设计：我们创建了两个福利限制措施。首先，我们计算了每个州医疗补助计划所覆盖的成瘾治疗服务的数量。在第二个例子中，我们计算了施加在每个服务上的使用控制的总数。使用混合效应逻辑回归模型，我们估计了成瘾治疗的州医疗补助福利限制与成瘾治疗计划中医疗补助接受率的调整几率之间的关系。数据收集：研究数据来自695个成瘾治疗项目的全国代表性样本（回复率85.5%），来自47个州和哥伦比亚特区医疗补助计划的代表主要发现：在对成瘾治疗有更多限制性医疗补助福利的州，成瘾治疗计划接受医疗补助登记者的几率较低（AOR = 0.65; CI = 0.43，0.97）。医疗补助接受的预测概率为35.4%，在高度限制性的国家，483%，在中度限制性的国家，和61.2%，在最少的限制性states.Conclusions：成瘾治疗计划更有可能接受医疗补助的限制性较少的好处成瘾治疗的状态。项目所有权和技术基础设施在提高医疗补助接受度方面也发挥着重要作用。(C)2018爱思唯尔公司All rights reserved.
Objective: To assess the relationship of restrictions on Medicaid benefits for addiction treatment to Medicaid acceptance among addiction treatment programs.Data sources: We collected primary data from the 2013-2014 wave of the National Drug Abuse Treatment System Survey.Study design: We created two measures of benefits restrictiveness. In the first, we calculated the number of addiction treatment services covered by each state Medicaid program. In the second, we calculated the total number of utilization controls imposed on each service. Using a mixed-effects logistic regression model, we estimated the relationship between state Medicaid benefit restrictiveness for addiction treatment and adjusted odds of Medicaid acceptance among addiction treatment programs.Data collection: Study data come from a nationally-representative sample of 695 addiction treatment programs (85.5% response rate), representatives from Medicaid programs in forty-seven states and the District of Columbia (response rate 92%), and data collected by the American Society for Addiction Medicine.Principal findings: Addiction treatment programs in states with more restrictive Medicaid benefits for addiction treatment had lower odds of accepting Medicaid enrollees (AOR = 0.65; CI = 0.43, 0.97). The predicted probability of Medicaid acceptance was 35.4% in highly restrictive states, 483% in moderately restrictive states, and 61.2% in the least restrictive states.Conclusions: Addiction treatment programs are more likely to accept Medicaid in states with less restrictive benefits for addiction treatment. Program ownership and technological infrastructure also play an important role in increasing Medicaid acceptance. (C) 2018 Elsevier Inc. All rights reserved.