Massachusetts Health Reform's Effect on Hospitalizations with Substance Use Disorder-Related Diagnoses.
Massachusetts Health Reform's Effect on Hospitalizations with Substance Use Disorder-Related Diagnoses.
复制标题
马萨诸塞州医疗改革对药物使用障碍相关诊断住院的影响。
DOI：
10.1111/1475-6773.12710
复制
发表时间：
2018
影响因子：
3.4
通讯作者：
Kressin,NancyR
中科院分区：
文献类型：
--
作者：
Lasser,KarenE;Hanchate,AmreshD;McCormick,Danny;Walley,AlexanderY;Saitz,Richard;Lin,Meng-Yun;Kressin,NancyR
目的探讨马萨诸塞州医疗改革对急诊科医院物质（酒精或药物）使用障碍（SUD）相关住院的影响。数据/研究设置2004 - 2010年MA住院出院数据。设计异中异分析，确定以年龄和性别标准化人群为基础的与SUD相关的内科和外科住院率的术前和术后变化，并根据长期趋势进行调整。数据提取方法我们确定了373,751例与SUD相关的出院诊断为原发性或继发性出院诊断。经年龄和性别调整后，改革前与药物使用相关和与酒精使用相关的住院率在高无保险县分别为7.21和8.87（每1000人），在低无保险县分别为8.58和9.63。在医疗改革后，高无保险县和低无保险县的SUD相关率均有所上升。调整高保险和低保险县的长期趋势，医疗改革与药物或酒精相关住院没有变化。结论马萨诸塞州医疗改革与物质使用障碍相关住院治疗的任何变化无关。除了扩大保险范围外，还需要进一步的研究来确定如何减少与物质使用障碍相关的住院治疗。
ObjectiveTo examine whether Massachusetts (MA) health reform affected substance (alcohol or drug) use disorder (SUD)–related hospitalizations in acute care hospitals.Data/Study Setting2004–2010 MA inpatient discharge data.DesignDifference‐in‐differences analysis to identify pre‐ to postreform changes in age‐ and sex‐standardized population‐based rates of SUD‐related medical and surgical hospitalizations, adjusting for secular trends.Data Extraction MethodsWe identified 373,751 discharges where a SUD‐related diagnosis was a primary or secondary discharge diagnosis.FindingsAdjusted for age and sex, the rates of drug use–related and alcohol use–related hospitalizations prereform were 7.21 and 8.87 (per 1,000 population), respectively, in high‐uninsurance counties, and 8.58 and 9.63, respectively, in low‐uninsurance counties. Both SUD‐related rates increased after health reform in high‐ and low‐uninsurance counties. Adjusting for secular trends in the high‐ and low‐uninsurance counties, health reform was associated with no change in drug‐ or alcohol‐related hospitalizations.ConclusionsMassachusetts health reform was not associated with any changes in substance use disorder–related hospitalizations. Further research is needed to determine how to reduce substance use disorder–related hospitalizations, beyond expanding insurance coverage.