Improving Access and Quality of care for Medicaid-Eligible Adults with Opioid Use Disorder

改善患有阿片类药物使用障碍且符合医疗补助资格的成年人的护理机会和质量

• 批准号: 9445428
• 负责人: BRENDAN K SALONER
• 金额: $ 18.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9445428
• 关键词: Address; Adult; Affordable Care Act; American; Area; Award; Buprenorphine; Categories; Censuses; Cessation of life; Clinical; Communicable Diseases; Communities; Community Surveys; Cost Effectiveness Analysis; Data; Diagnosis; Disease; Drug usage; Eligibility Determination; Employment; Endocarditis; Enrollment; Epidemic; Evaluation; Evidence based treatment; Freedom; Funding; Future; Geography; HIV; Health; Health Insurance; Health Personnel; Health Services Accessibility; Health Status; Hepatitis; Heroin; Impact evaluation; Improve Access; Individual; Injury; Insurance; Insurance Coverage; Knowledge; Link; Location; Low income; Maps; Maryland; Measurement; Measures; Medicaid; Medicaid eligibility; Medicine; Mentored Research Scientist Development Award; Mentorship; Methods; Modeling; National Institute of Drug Abuse; Opioid Analgesics; Outcome; Overdose; Personal Satisfaction; Persons; Pharmaceutical Preparations; Policies; Population; Provider; Public Health Schools; Publishing; Quality of Care; Quality-Adjusted Life Years; Research; Research Personnel; Resource Allocation; Resources; Risk; Sampling; Services; Source; Structure; Substance Use Disorder; Suicide attempt; Surveys; System; Training; Travel; Treatment Cost; Treatment Effectiveness; Treatment outcome; Underserved Population; United States; Wages; West Virginia; Work; Writing; addiction; behavioral health; beneficiary; career; cohort; cost; cost effectiveness; cost-effectiveness evaluation; cost-effectiveness ratio; critical period; design; experience; heroin overdose; heroin use; improved; incremental cost-effectiveness; medication-assisted treatment; methadone treatment; mortality; opioid misuse; opioid overdose; opioid use disorder; overdose death; payment; population health; practical application; prescription opioid; prescription opioid misuse; prior authorization; professor; programs; public health priorities; skills; social; statistics; treatment services

PROJECT SUMMARY/ABSTRACT Drug overdose is now the most common cause of injury death in the United States, and opioid analgesics are involved in almost half of these deaths. Overdose deaths have quadrupled since the late 1990s, corresponding to rising misuse of opioid analgesics and heroin. Increasing access to medication-assisted treatment (MAT) such as methadone maintenance and buprenorphine is one important strategy for addressing opioid use disorder (OUD). Expanded Medicaid eligibility for low-income adults could increase use of OUD treatment among low-income adults with inconsistent insurance coverage. Expanding eligibility for Medicaid may be most effective in reducing OUD if Medicaid programs offer comprehensive MAT coverage and treatment providers locate in areas where new Medicaid enrollees are likely to require services. This application for a National Institute on Drug Abuse Mentored Research Scientist Development Award (K01) seeks support for a new Assistant Professor at the Johns Hopkins Bloomberg School of Public Health who aspires to a career focused on improving publicly-funded services and systems that treat individuals with substance use disorders, particularly OUD. Dr. Saloner's prior research has focused on access to care for behavioral health disorders and on health insurance. To extend the reach and scope of this research, Dr. Saloner proposes to move his research toward clinical outcomes, resource allocation and value measurement, impact evaluation, and geospatial analysis. Accordingly, the K01 training is focused on gaining knowledge in addiction medicine, cost effectiveness analysis, causal inference, and spatial statistics. The proposed research will employ mixed methods to study the multiple determinants of access to OUD treatment for low-income adults. Research aims will include (1) an evaluation of how expansions of Medicaid eligibility for low-income adults have impacted use of treatment services, health, and social outcomes among low-income adults with OUD; (2) a geographic analysis to identify clusters where individuals with OUD reside, and to examine the proximity of those clusters to treatment resources and to areas with high Medicaid enrollment; (3) a detailed analysis of how access to medication-assisted treatments in two different state Medicaid programs is associated with treatment costs and health outcomes. The practical application of this work will be to guide efforts by states and localities to more effectively target resources to individuals with OUD. By providing salary support, training, freedom from administrative responsibilities, and a formal mentorship structure, this award will facilitate Dr. Saloner's transition to an independent research career focused on improving health and social outcomes among persons with OUD.

项目摘要/摘要 吸毒过量现在是美国最常见的伤害死亡原因，阿片类药物 在这些死亡中，几乎有一半与止痛药有关。自20世纪90年代末以来，服药过量死亡人数增加了四倍， 与滥用阿片类镇痛剂和海洛因的情况相对应。增加获得药物辅助的机会 美沙酮维持和丁丙诺啡等治疗(MAT)是解决 阿片使用障碍(OUD)。扩大低收入成年人的医疗补助资格可能会增加OUD的使用 对保险覆盖范围不一致的低收入成年人的治疗。扩大享受医疗补助的资格 如果医疗补助计划提供全面的垫子覆盖范围和 治疗提供者位于新的医疗补助参与者可能需要服务的地区。 申请国家药物滥用研究所指导研究科学家发展 奖项(K01)寻求支持约翰霍普金斯大学彭博公共学院的一名新助理教授 渴望从事专注于改善公共资助的服务和治疗系统的职业的健康人士 有药物使用障碍的人，特别是OUD。塞隆纳博士之前的研究重点是访问 照顾行为健康障碍和医疗保险。要扩大这一项目的覆盖范围和范围 研究方面，塞隆纳博士建议将他的研究转向临床结果、资源分配和价值 测量、影响评估和地理空间分析。因此，K01培训的重点是获得 了解成瘾医学、成本效益分析、因果推断和空间统计学。 拟议的研究将使用混合方法来研究获得的多种决定因素 为低收入成年人提供OUD治疗。研究目标将包括(1)评估如何扩展 低收入成年人的医疗补助资格影响了治疗服务的使用、健康和社会结果 在低收入成年人中有OUD；(2)确定有OUD的个人所在的集群的地理分析 居住，并检查这些集群与治疗资源和医疗补助较高地区的接近程度 登记；(3)详细分析两个不同州如何获得药物辅助治疗 医疗补助计划与治疗成本和健康结果有关。这一点的实际应用 工作将是指导州和地方的努力，以更有效地将资源定向到有以下条件的个人 奥德。通过提供工资支持、培训、免除行政责任和正式的 导师结构，该奖项将促进塞隆纳博士向独立研究生涯的过渡 重点是改善OUD患者的健康和社会结果。