Linking State Data to Identify Unmet Alcohol Treatment Need in Women aged 15-49

连接州数据以确定 15-49 岁女性未满足的酒精治疗需求

• 批准号: 8149880
• 负责人: Judith Apt Bernstein
• 金额: $ 19.65万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8149880
• 关键词: Accident and Emergency department; Address; Admission activity; Age; Alcohol abuse; Alcohol dependence; Alcohols; Algorithms; Birth; Birth Records; Boston; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Child; Child health care; Collaborations; Congenital Abnormality; Data; Data Set; Data Sources; Databases; Dependence; Detox; Development; Diagnosis; Early treatment; Enabling Factors; Epidemiology; Fetal Death; Frequencies; Funding; Health; Hospitals; Individual; Infant; Information Systems; Intervention; Life; Link; Massachusetts; Maternal Health; Measures; Medical History; Methods; Modality; Modeling; Mothers; Multivariate Analysis; National Institute of Drug Abuse; Neonatal; Outcome; Pathway interactions; Patient Self-Report; Pattern; Pediatric Hospitals; Pharmaceutical Preparations; Population; Predisposing Factor; Pregnancy; Pregnancy Outcome; Premature Birth; Prevalence; Public Health; Public Health Schools; Recording of previous events; Records; Registries; Reproductive History; Research Personnel; Risk; Services; Societies; Substance abuse problem; System; Testing; Time; United States National Institutes of Health; Universities; Visit; Vital Statistics; Woman; administrative database; aged; alcohol abuse therapy; alcohol related problem; alcohol services; base; clinically significant; early childhood; health care delivery; hospital utilization; improved; innovation; meetings; population based; pregnant; premature; programs; public health relevance; reproductive; substance abuse treatment; treatment program

DESCRIPTION (provided by applicant): Alcohol treatment programs know who they serve, but can only estimate who they do not serve; the inability to accurately measure unmet treatment need, especially among women of reproductive age, is a key barrier to developing interventions to reduce alcohol-related health consequences for women, their children, and society. This proposal describes an innovative collaboration to link two existing independent state data systems to create a new, unique longitudinal, epidemiologic database that combines alcohol/drug treatment data with hospital utilization and health outcomes data, to broadly identify alcohol-related problems and the prevalence of unmet treatment need, and to track alcohol-related health outcomes among Massachusetts women of reproductive age and their children. For the first time, women in need of alcohol treatment services who did not receive them will be individually identifiable, allowing for better estimation and description of unmet need. The new linked data will permit assessment of disparities among women with met and unmet treatment need through multiple sources of data, including using a tested algorithm to identify alcohol diagnoses in hospital data. Moreover, the linked data will allow the examination of subsequent health outcomes among women ages 15-49, and birth outcomes among their children. The two data sources to be linked are: (1) the population- based MA Pregnancy to Early Life Longitudinal (PELL) data system, that includes vital records (births, fetal deaths and deaths); hospital discharge, observational stay, and emergency department visit records; and the MA Birth Defects Registry; and (2) the MA Bureau of Substance Abuse Services (BSAS) treatment data system that contains treatment records for over 25,000 annual admissions of women of reproductive age to BSAS-funded substance abuse treatment facilities. The three broad study aims are: 1. Link PELL data to the MDPH-BSAS Treatment Database and verify linkages. 2. Develop and pilot methods a) among all MA women of reproductive age, identify women with alcohol abuse or dependence (2002-2007), assess unmet need for treatment services, and characterize disparities in treatment use, overall and by type (none, detox only, definitive); b) among MA women who had deliveries (2003-2006), describe the pattern of identification and treatment of alcohol problems in the periods before, during, and after pregnancy, assess unmet need for alcohol treatment by type and timing, and characterize pregnancy outcomes; and c) among MA women with an identified alcohol problem develop preliminary multivariate models with predisposing and enabling factors predicting receipt of treatment overall and by type, and, among women who delivered, risk for prematurity. 3. Develop an R01 proposal to describe the impact of substance abuse and treatment on women's and children's health, based on bivariate and multivariate analyses proposed for this study and a tandem NIH/NIDA study. PUBLIC HEALTH RELEVANCE: This innovative public-private collaboration links two existing independent state data systems (BSAS and PELL) to create a new, unique longitudinal, epidemiologic database that combines alcohol/drug treatment data with hospital utilization and health outcomes data, to broadly identify alcohol-related problems and the prevalence of unmet treatment need, and to track alcohol-related health and birth outcomes among Massachusetts women of reproductive age. For the first time, women in need of alcohol treatment services who did not receive them will be individually identifiable, allowing for accurate estimation and description of unmet need, a critical step to improve State alcohol treatment programs for women of reproductive age.

描述（由申请人提供）：酒精治疗计划知道他们服务的对象，但只能估计他们不服务的对象；无法准确衡量未满足的治疗需求，尤其是育龄妇女的未满足治疗需求，是制定干预措施以减少酒精相关健康对妇女及其子女和社会造成影响的主要障碍。该提案描述了一项创新合作，将两个现有的独立州数据系统连接起来，创建一个新的、独特的纵向流行病学数据库，将酒精/药物治疗数据与医院利用率和健康结果数据结合起来，广泛识别与酒精相关的问题和未满足治疗需求的普遍情况，并跟踪马萨诸塞州育龄妇女及其子女与酒精相关的健康结果。首次对需要酒精治疗服务但未接受治疗的女性进行单独识别，以便更好地估计和描述未满足的需求。新的关联数据将允许通过多种数据来源评估满足和未满足治疗需求的女性之间的差异，包括使用经过测试的算法来识别医院数据中的酒精诊断。此外，关联数据将允许检查 15-49 岁女性的后续健康结果及其子女的出生结果。需要链接的两个数据源是： (1) 基于人口的 MA 妊娠至早期生命纵向 (PELL) 数据系统，其中包括重要记录（出生、胎儿死亡和死亡）；出院、观察和急诊科就诊记录；以及马萨诸塞州出生缺陷登记处； (2) 马萨诸塞州药物滥用服务局 (BSAS) 治疗数据系统，其中包含每年 25,000 多名育龄妇女入住 BSAS 资助的药物滥用治疗机构的治疗记录。三大研究目标是： 1. 将 PELL 数据链接到 MDPH-BSAS 治疗数据库并验证链接。 2. 制定和试点方法 a) 在所有 MA 育龄妇女中，查明酗酒或酗酒的妇女（2002-2007 年），评估未满足的治疗服务需求，并描述总体和按类型（无、仅戒毒、明确）治疗使用方面的差异； b) 在生育过的 MA 妇女中（2003-2006 年），描述怀孕前、怀孕期间和怀孕后酒精问题的识别和治疗模式，按类型和时间评估未满足的酒精治疗需求，并描述妊娠结局； c) 在已确定有酗酒问题的 MA 妇女中，建立初步的多变量模型，其中包含预测总体和按类型接受治疗的诱发因素和促进因素，以及在分娩的妇女中，预测早产风险。 3. 根据本研究和 NIH/NIDA 串联研究提出的双变量和多变量分析，制定 R01 提案，描述药物滥用和治疗对妇女和儿童健康的影响。 公共健康相关性：这种创新的公私合作将两个现有的独立州数据系统（BSAS 和 PELL）连接起来，创建一个新的、独特的纵向流行病学数据库，将酒精/药物治疗数据与医院利用率和健康结果数据结合起来，广泛识别与酒精相关的问题和未满足治疗需求的普遍情况，并跟踪马萨诸塞州育龄妇女与酒精相关的健康和出生结果。第一次，需要酒精治疗服务但未接受服务的妇女将被单独识别，从而能够准确估计和描述未满足的需求，这是改善国家育龄妇女酒精治疗计划的关键一步。

项目成果

The association of injury with substance use disorder among women of reproductive age: an opportunity to address a major contributor to recurrent preventable emergency department visits?

• DOI: 10.1111/acem.12548
• 发表时间: 2014-12
• 期刊: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
• 作者: Bernstein J;Bernstein E;Belanoff C;Cabral HJ;Babakhanlou-Chase H;Derrington TM;Diop H;Douriez C;Evans SR;Jacobs H;Kotelchuck M
• 通讯作者: Kotelchuck M