Access to medication-assisted treatment in the United States: Comparison of travel time to opioid treatment programs and office-based buprenorphine treatment
Access to medication-assisted treatment in the United States: Comparison of travel time to opioid treatment programs and office-based buprenorphine treatment
复制标题
DOI：
10.1016/j.drugalcdep.2021.108727
复制
发表时间：
2021-05-04
影响因子：
4.2
通讯作者：
Amram, Ofer
中科院分区：
文献类型：
--
作者：
Amiri, Solmaz;Hirchak, Katherine;Amram, Ofer
目标：在获得药物辅助治疗方面的差距是一个主要问题。本研究估计并比较了最近的阿片类药物治疗计划（OTP）和办公室为基础的丁丙诺啡治疗（OBBT）在美国城乡连续体的驾驶时间。方法：计算驾驶时间之间的经度和纬度的人口加权块组质心和经度和纬度的最近的OTP和OBBT。农村-城市通勤区（RUCA）代码用于定义农村。采用集成嵌套拉普拉斯近似法进行统计分析。结果如下：与OTP相比，到最近的OBBT的平均旅行时间减少了7.18分钟（95% CI = 7.23-7.14）在大都市核心区，36.63 min（95%CI = 37.12-36.15），小城镇为38.84 min（95%CI = 39.57-38.10），农村为40.16 min（95%CI = 40.81-39.50）。此外，13 526 605人前往最近的检察官办公室的旅行负担超过60分钟，5 371 852人超过90分钟。845，991人到最近的OBBT的旅行负担超过60分钟，149，297人超过90分钟。结论：到达最近OBBT的平均驾驶时间显著小于到达最近OTP的平均驾驶时间。有必要分析获得治疗的障碍，以制定创造性举措，改善获得严重阿片类药物使用障碍治疗服务的机会。
Objectives: Disparities in access to medication-assisted treatment are a major problem. This study estimated and compared drive time to the nearest opioid treatment program (OTP) and office-based buprenorphine treatment (OBBT) across the urban-rural continuum in the U.S. Methods: Drive time was calculated between the longitude and latitude of population weighted block group centroids and the longitude and latitude of the nearest OTP and OBBT. Rural-Urban Commuting Area (RUCA) codes were used for defining rurality. The Integrated Nested Laplace Approximation approach was used for statistical analysis. Results: The mean travel time to the nearest OBBT compared to OTP decreased by 7.18 min (95 % CI = 7.23-7.14) in metropolitan cores, 36.63 min (95 % CI = 37.12-36.15) in micropolitan cores, 38.84 min (95 % CI = 39.57-38.10) in small town cores, and 40.16 min (95 % CI = 40.81-39.50) in rural areas. Additionally, travel burden to the nearest OTP would be more than 60 min for 13,526,605 people and more than 90 min for 5,371,852 people. The travel burden to the nearest OBBT would be more than 60 min for 845,991 people and more than 90 min for 149,297 people. Conclusions: The mean drive time to the closest OBBT was significantly smaller than the mean drive time to the closest OTP. Analysis of barriers to access is necessary to devising creative initiatives to improve access to critical opioid use disorder treatment services.