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Misalignment of Stakeholder Incentives in the Opioid Crisis
The current opioid epidemic has killed more than 446,000 Americans over the past two decades. Despite the magnitude of the crisis, little is known to what degree the misalignment of incentives among stakeholders due to competing interests has contributed to the current situation. In this study, we e...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589670/ https://www.ncbi.nlm.nih.gov/pubmed/33081276 http://dx.doi.org/10.3390/ijerph17207535 |
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author | Boloori, Alireza Arnetz, Bengt B. Viens, Frederi Maiti, Taps Arnetz, Judith E. |
author_facet | Boloori, Alireza Arnetz, Bengt B. Viens, Frederi Maiti, Taps Arnetz, Judith E. |
author_sort | Boloori, Alireza |
collection | PubMed |
description | The current opioid epidemic has killed more than 446,000 Americans over the past two decades. Despite the magnitude of the crisis, little is known to what degree the misalignment of incentives among stakeholders due to competing interests has contributed to the current situation. In this study, we explore evidence in the literature for the working hypothesis that misalignment rooted in the cost, quality, or access to care can be a significant contributor to the opioid epidemic. The review identified several problems that can contribute to incentive misalignment by compromising the triple aims (cost, quality, and access) in this epidemic. Some of these issues include the inefficacy of conventional payment mechanisms in providing incentives for providers, practice guidelines in pain management that are not easily implementable across different medical specialties, barriers in adopting multi-modal pain management strategies, low capacity of providers/treatments to address opioid/substance use disorders, the complexity of addressing the co-occurrence of chronic pain and opioid use disorders, and patients’ non-adherence to opioid substitution treatments. In discussing these issues, we also shed light on factors that can facilitate the alignment of incentives among stakeholders to effectively address the current crisis. |
format | Online Article Text |
id | pubmed-7589670 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75896702020-10-29 Misalignment of Stakeholder Incentives in the Opioid Crisis Boloori, Alireza Arnetz, Bengt B. Viens, Frederi Maiti, Taps Arnetz, Judith E. Int J Environ Res Public Health Review The current opioid epidemic has killed more than 446,000 Americans over the past two decades. Despite the magnitude of the crisis, little is known to what degree the misalignment of incentives among stakeholders due to competing interests has contributed to the current situation. In this study, we explore evidence in the literature for the working hypothesis that misalignment rooted in the cost, quality, or access to care can be a significant contributor to the opioid epidemic. The review identified several problems that can contribute to incentive misalignment by compromising the triple aims (cost, quality, and access) in this epidemic. Some of these issues include the inefficacy of conventional payment mechanisms in providing incentives for providers, practice guidelines in pain management that are not easily implementable across different medical specialties, barriers in adopting multi-modal pain management strategies, low capacity of providers/treatments to address opioid/substance use disorders, the complexity of addressing the co-occurrence of chronic pain and opioid use disorders, and patients’ non-adherence to opioid substitution treatments. In discussing these issues, we also shed light on factors that can facilitate the alignment of incentives among stakeholders to effectively address the current crisis. MDPI 2020-10-16 2020-10 /pmc/articles/PMC7589670/ /pubmed/33081276 http://dx.doi.org/10.3390/ijerph17207535 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Boloori, Alireza Arnetz, Bengt B. Viens, Frederi Maiti, Taps Arnetz, Judith E. Misalignment of Stakeholder Incentives in the Opioid Crisis |
title | Misalignment of Stakeholder Incentives in the Opioid Crisis |
title_full | Misalignment of Stakeholder Incentives in the Opioid Crisis |
title_fullStr | Misalignment of Stakeholder Incentives in the Opioid Crisis |
title_full_unstemmed | Misalignment of Stakeholder Incentives in the Opioid Crisis |
title_short | Misalignment of Stakeholder Incentives in the Opioid Crisis |
title_sort | misalignment of stakeholder incentives in the opioid crisis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589670/ https://www.ncbi.nlm.nih.gov/pubmed/33081276 http://dx.doi.org/10.3390/ijerph17207535 |
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