Developing Implementation Strategies to Improve Access to Transitional Opioid Programs in Safety Net Hospitals

制定实施策略以改善安全网医院过渡性阿片类药物计划的可及性

• 批准号: 10671082
• 负责人: Ji E Chang
• 金额: $ 23.46万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10671082
• 关键词: Acute; Address; Adopted; Adoption; Budgets; Buprenorphine; Caring; Catalogs; Centers for Disease Control and Prevention (U.S.); Characteristics; Chronic; Collaborations; Communicable Diseases; Communities; Community Hospitals; Data; Decision Making; Disparity; Economic Burden; Economics; Endocarditis; Ensure; Evidence based program; Extramural Activities; Face; Funding; Future; Goals; HIV/HCV; Harm Reduction; Health; Health Services; Health Services Accessibility; Healthcare Systems; Hospitalization; Hospitals; Improve Access; Institution; Interdisciplinary Health Team; Intervention; Interview; Investments; Knowledge; Link; Logistic Regressions; Medicaid; Methods; Morbidity - disease rate; Opioid; Outcome; Outpatients; Overdose; Patients; Pattern; Persons; Play; Provider; Public Health; Publications; Randomized, Controlled Trials; Reporting; Research; Research Personnel; Resources; Role; Sampling; Schedule; Service provision; Services; Site; Skin Tissue; Soft Tissue Infections; Stress; Testing; Time; Typology; Underinsured; Uninsured; United States; addiction; beneficiary; community barrier; community based service; community partnership; disease transmission; effectiveness testing; evidence base; follow-up; implementation barriers; implementation science; implementation strategy; improved; longitudinal database; medication for opioid use disorder; mortality; opioid misuse; opioid overdose; opioid use; opioid use disorder; patient engagement; programs; rural setting; safety net; secondary infection; social; social stigma; trend; underserved community; uptake; urban setting

Project Summary/Abstract: Opioid use disorder (OUD) is a pressing public health problem nationwide but is increasing rapidly in underserved communities where there is currently a shortage of services, particularly evidence-based transitional opioid programs (TOPs) which link patients in hospitals to harm reduction and treatment resources. Hospitals are ideal sites to address OUD and engage patients given the relationship between opioid use and misuse and a number of acute health conditions, including overdose and infectious disease. Evidence suggests that hospitals are highly motivated to participate in offering new interventions due to the economic and social toll of untreated OUD. Safety net hospitals, however, face considerable barriers to adopting TOPs and have been significantly less likely to offer OUD services in their communities. To engage safety-net hospitals effectively and help them implement opioid programs such as TOPs, more information is needed on implementation barriers to tailor implementation strategies that will be most effective given the local constraints faced by safety-net providers. Using a combination of the latest publicly available community benefits reports and Internal Revenue Service Schedule H data, we will catalog hospitals’ OUD services, including TOPs, and assess the relationship between the adoption of TOP and various community and hospital characteristics, including safety-net status, and examine trends in the availability of OUD services across time (Aim 1). We will then interview hospital decision makers and community partners at five diverse safety net hospitals to better understand barriers and facilitators to adopting and implementing TOPs. (Aim 2). Finally, we will convene an expert panel to identify high-yield and tailored implementation strategies to increase the availability of transitional opioid programs and other evidence-based opioid services in underserved communities (Aim 3). As an interdisciplinary team of health services researchers, we have a strong record of collaborative publication and extramural funding related to hospital-community partnerships and opioid services. The implementation strategies developed in this study will lead to a future cluster randomized controlled trial to test the effectiveness of tailoring implementation strategies to safety net settings. The long term outcome is to increase the availability of TOPs in communities where significant disparities currently exist.

项目摘要/摘要： 阿片类药物使用障碍（OUD）在全国范围内是一个紧迫的公共卫生问题，但正在迅速增加 服务欠缺的社区目前缺乏服务，尤其是基于证据的社区 过渡性阿片类药物计划（TOPS）将医院的患者与损害减少和治疗资源联系起来。 鉴于阿片类药物使用之间的关系和 滥用和许多急性健康状况，包括过量和传染病。证据 建议医院高度动力参与由于经济而提供新的干预措施 和未经处理的Oud的社会损失。但是，安全网医院面临着采用上衣的障碍 并且在其社区提供Oud服务的可能性大大降低。参与安全网 有效的医院并帮助他们实施阿片类药物计划，例如上衣，需要更多信息 考虑到本地限制，量身定制实施策略的实施障碍将是最有效的 面对安全网的提供商。 结合最新公开可用的社区福利报告和内部收入 服务附表H数据，我们将分类医院的Oud服务，包括顶部，并评估关系 在采用顶部和各种社区和医院特征（包括安全网络状态）之间 并检查跨时间的OUD服务可用性的趋势（AIM 1）。然后我们将面试医院 五家潜水员安全网医院的决策者和社区合作伙伴更好地了解障碍和 采用和实施顶部的促进者。 （目标2）。最后，我们将召集专家小组以识别 高收益和量身定制的实施策略，以提高过渡性阿片类药物计划的可用性和 在服务不足的社区中的其他基于证据的阿片类药物服务（AIM 3）。作为一个跨学科团队 卫生服务研究人员，我们有合作出版和校外资金的良好记录 与医院社区伙伴关系和阿片类药物服务有关。实施策略在 这项研究将导致未来的群集随机对照试验，以测试剪裁的有效性 安全网设置的实施策略。长期结果是增加顶部的可用性 在目前存在重大分布的社区中。