The Role of Primary Care in Improving Access to Medication-Assisted Treatment for Rural Medicaid Enrollees with Opioid Use Disorder
| Autor: | Ellen DiDomenico, Evan S. Cole, Janice L. Pringle, Gerald Cochran, Chung-Chou H. Chang, Julie M. Donohue, Joo Yeon Kim, Julie Kmiec, Jack Warwick, Adam J. Gordon, David Kelley, Walid F. Gellad |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Rural Population medicine.medical_specialty Adolescent Health Personnel 01 natural sciences Health Services Accessibility Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Health care Opiate Substitution Treatment Internal Medicine medicine Humans 030212 general & internal medicine 0101 mathematics Medical prescription Retrospective Studies Original Research Primary Health Care Medicaid business.industry 010102 general mathematics Opioid use disorder Retrospective cohort study Middle Aged Opioid-Related Disorders medicine.disease United States Family medicine Female Rural area business Buprenorphine medicine.drug |
| Zdroj: | J Gen Intern Med |
| ISSN: | 1525-1497 0884-8734 |
| Popis: | BACKGROUND: The opioid epidemic has disproportionately affected rural areas, where a limited number of health care providers offer medication-assisted treatment (MAT), the mainstay of treatment for opioid use disorder (OUD). Rural residents with OUD may face multiple barriers to engagement in MAT including long travel distances. OBJECTIVE: To examine the degree to which rural residents with OUD are engaged with primary care providers (PCPs), describe the role of rural PCPs in MAT delivery, and estimate the association between enrollee distance to MAT prescribers and MAT utilization. DESIGN: Retrospective cohort study. PARTICIPANTS: Medicaid-enrolled adults diagnosed with OUD in 23 rural Pennsylvania counties. MAIN MEASURES: Primary care utilization, MAT utilization, distance to nearest possible MAT prescriber, mean distance traveled to actual MAT prescribers, and continuity of pharmacotherapy. KEY RESULTS: Of the 7930 Medicaid enrollees with a diagnosis of OUD, a minority (18.6%) received their diagnosis during a PCP visit even though enrollees with OUD had 4.1 visits to PCPs per person-year in 2015. Among enrollees with an OUD diagnosis recorded during a PCP visit, about half (751, 50.8%) received MAT, most of whom (508, 67.6%) received MAT from a PCP. Enrollees with OUD with at least one PCP visit were more likely than those without a PCP visit to receive MAT (32.7% vs. 25%; p |
| Databáze: | OpenAIRE |
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