How Patient Centered Are Addiction Treatment Intake Processes?
How Patient Centered Are Addiction Treatment Intake Processes?
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DOI：
10.1097/adm.0000000000000714
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发表时间：
2021-03-01
影响因子：
5.5
通讯作者：
Treiman, Katherine
中科院分区：
文献类型：
--
作者：
Mark, Tami L.;Hinde, Jesse;Treiman, Katherine
目的：物质使用障碍（SUD）治疗领域已经进行了大量的研究，以创建最适合患者的摄入工具和过程，以最合适的治疗环境，但对这些工具如何影响患者体验的研究较少。该研究利用了在加州进行的一项自然实验，以评估美国成瘾医学会（ASAM）评估标准的实施和基于ASAM标准的计算机辅助摄入评估是否会影响患者的体验和摄入期间的以患者为中心，相对于接受非基于ASAM标准的摄入评估的患者。研究方法：我们分析了Medi-Cal覆盖的851名患者完成的调查，这些患者在加州10个县的33家提供商接受专科SUD治疗，了解他们对摄入评估过程的经验和看法。为了解释患者组合的差异，我们使用了逆概率加权，并计算了非ASAM、ASAM和计算机化ASAM患者的加权均值差异。结果如下：我们发现，根据ASAM评估标准或计算机化ASAM评估进行摄入的患者经历了更多以患者为中心的摄入。我们还发现，接受基于ASAM评估的患者对他们选择的治疗环境更满意。结论：这一证据对于SUD治疗领域是令人鼓舞的，特别是考虑到许多医疗补助计划正在采用ASAM或类似的患者安置标准和多维评估。未来的研究应考虑是否增加以患者为中心的评估与SUD治疗和其他积极的治疗结果的保留增加。
Objectives: The substance use disorder (SUD) treatment field has conducted significant research on creating intake tools and processes that best match patients to the most appropriate treatment setting, but less research has been conducted on how those tools impact the patient experience. The study took advantage of a natural experiment in California to evaluate whether the implementation of American Society of Addiction Medicine (ASAM) assessment criteria and a computer-facilitated intake assessment based on the ASAM criteria affects patient experiences and patient-centeredness during intake relative to patients receiving intake assessments not based on ASAM criteria. Methods: We analyzed surveys completed by 851 patients covered by Medi-Cal who were receiving specialty SUD treatment at 33 providers across 10 California counties about their experiences and perceptions of the intake assessment process. To account for differences in patient mix, we used inverse-probability weighting and computed differences in the weighted means for patients across non-ASAM, ASAM, and computerized-ASAM patients. Results: We have found that patients who underwent intake based on ASAM assessment criteria or computerized ASAM assessment experienced a more patient-centered intake. We also found that patients who received ASAM-based assessments were more satisfied with their choice of treatment setting. Conclusions: This evidence is encouraging for the SUD treatment field, especially considering that many Medicaid programs are adopting ASAM or similar patient placement criteria and multidimensional assessments. Future research should consider whether increases in the patient-centeredness of assessments are associated with increased retention in SUD treatment and other positive treatment outcomes.