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Disparities in Opioid Use Disorder Treatment Admissions
OBJECTIVES: The Cincinnati region has been at the epicenter of the nation’s unfolding opioid epidemic. The objectives of this study were twofold: (1) to compare the Cincinnati region to the United States in length of time to obtain treatment and planned medication-assisted therapy for the treatment...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Columbia Data Analytics, LLC
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343341/ https://www.ncbi.nlm.nih.gov/pubmed/32685601 http://dx.doi.org/10.36469/jheor.2020.13266 |
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author | Mallow, Peter J. Mercado, Michael Topmiller, Michael |
author_facet | Mallow, Peter J. Mercado, Michael Topmiller, Michael |
author_sort | Mallow, Peter J. |
collection | PubMed |
description | OBJECTIVES: The Cincinnati region has been at the epicenter of the nation’s unfolding opioid epidemic. The objectives of this study were twofold: (1) to compare the Cincinnati region to the United States in length of time to obtain treatment and planned medication-assisted therapy for the treatment for opioid use disorder (OUD); and (2) to assess racial disparities within the Cincinnati region in wait time and type of treatment. METHODS: The 2017 Treatment Episode Data Set: Admissions (TEDS-A) from the Substance Abuse and Mental Health Services Administration (SAMHSA) was used to identify a cohort of eligible individuals with a primary substance use of opioids, including opioid derivatives. Logistic regression models were performed to assess the differences for treatment wait time and type of planned treatment. Model covariates included patient demographics and socioeconomic characteristics. Three different models were performed to assess the influence of covariates of the outcomes. RESULTS: There were 678 766 US and 3298 Cincinnati region individuals admitted for OUD treatment in 2017. The rate per 1000 for treatment admissions was 2.08 and 1.51 (P value < 0.0001) for the United States and Cincinnati, respectively. The fully saturated regression results found that the odds of Cincinnati individuals receiving planned medication-assisted therapy were 0.497 (95% CI, 0.451–0.546; P value < 0.001). The odds of waiting longer for treatment in Cincinnati were higher than in the United States as a whole: 2.33 (95% CI, 2.19–2.48; P value < 0.001). In Cincinnati, there were 3102 Caucasian, 123 African American, and 73 Other admissions. The fully saturated model results found that Caucasians and Other had an increased likelihood of receiving planned medicationassisted therapy (OR 1.89, P value 0.039; OR 7.07, P value 0.002, respectively) compared to African Americans. Within Cincinnati, there was not a statistically significant difference in the likelihood of waiting time to receive treatment by race. CONCLUSION: Individuals seeking treatment for OUD in Cincinnati were less likely to receive planned medication-assisted therapy and were more likely to wait longer than individuals in the United States as a whole. These results suggest that the demand for treatment is greater than the supply in Cincinnati. Within Cincinnati, there does not appear to be a racial disparity in treatment type or length of time to receive treatment for OUD. |
format | Online Article Text |
id | pubmed-7343341 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Columbia Data Analytics, LLC |
record_format | MEDLINE/PubMed |
spelling | pubmed-73433412020-07-16 Disparities in Opioid Use Disorder Treatment Admissions Mallow, Peter J. Mercado, Michael Topmiller, Michael J Health Econ Outcomes Res Methodology and Health Care Policy OBJECTIVES: The Cincinnati region has been at the epicenter of the nation’s unfolding opioid epidemic. The objectives of this study were twofold: (1) to compare the Cincinnati region to the United States in length of time to obtain treatment and planned medication-assisted therapy for the treatment for opioid use disorder (OUD); and (2) to assess racial disparities within the Cincinnati region in wait time and type of treatment. METHODS: The 2017 Treatment Episode Data Set: Admissions (TEDS-A) from the Substance Abuse and Mental Health Services Administration (SAMHSA) was used to identify a cohort of eligible individuals with a primary substance use of opioids, including opioid derivatives. Logistic regression models were performed to assess the differences for treatment wait time and type of planned treatment. Model covariates included patient demographics and socioeconomic characteristics. Three different models were performed to assess the influence of covariates of the outcomes. RESULTS: There were 678 766 US and 3298 Cincinnati region individuals admitted for OUD treatment in 2017. The rate per 1000 for treatment admissions was 2.08 and 1.51 (P value < 0.0001) for the United States and Cincinnati, respectively. The fully saturated regression results found that the odds of Cincinnati individuals receiving planned medication-assisted therapy were 0.497 (95% CI, 0.451–0.546; P value < 0.001). The odds of waiting longer for treatment in Cincinnati were higher than in the United States as a whole: 2.33 (95% CI, 2.19–2.48; P value < 0.001). In Cincinnati, there were 3102 Caucasian, 123 African American, and 73 Other admissions. The fully saturated model results found that Caucasians and Other had an increased likelihood of receiving planned medicationassisted therapy (OR 1.89, P value 0.039; OR 7.07, P value 0.002, respectively) compared to African Americans. Within Cincinnati, there was not a statistically significant difference in the likelihood of waiting time to receive treatment by race. CONCLUSION: Individuals seeking treatment for OUD in Cincinnati were less likely to receive planned medication-assisted therapy and were more likely to wait longer than individuals in the United States as a whole. These results suggest that the demand for treatment is greater than the supply in Cincinnati. Within Cincinnati, there does not appear to be a racial disparity in treatment type or length of time to receive treatment for OUD. Columbia Data Analytics, LLC 2020-06-22 /pmc/articles/PMC7343341/ /pubmed/32685601 http://dx.doi.org/10.36469/jheor.2020.13266 Text en This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CCBY-4.0). View this license’s legal deed at http://creativecommons.org/licenses/by/4.0 and legal code at http://creativecommons.org/licenses/by/4.0/legalcode for more information. |
spellingShingle | Methodology and Health Care Policy Mallow, Peter J. Mercado, Michael Topmiller, Michael Disparities in Opioid Use Disorder Treatment Admissions |
title | Disparities in Opioid Use Disorder Treatment Admissions |
title_full | Disparities in Opioid Use Disorder Treatment Admissions |
title_fullStr | Disparities in Opioid Use Disorder Treatment Admissions |
title_full_unstemmed | Disparities in Opioid Use Disorder Treatment Admissions |
title_short | Disparities in Opioid Use Disorder Treatment Admissions |
title_sort | disparities in opioid use disorder treatment admissions |
topic | Methodology and Health Care Policy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343341/ https://www.ncbi.nlm.nih.gov/pubmed/32685601 http://dx.doi.org/10.36469/jheor.2020.13266 |
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