QUALITY OF BUPRENORPHINE CARE FOR INSURED ADULTS WITH OPIOID USE DISORDER
| Autor: | Brendan Saloner, Kelly E. Anderson, Julia Eckstein, G. Caleb Alexander, Sydney M. Dy, Lauren Niles, Sarah Hudson Scholle, Christine E. Chaisson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Psychological intervention Medicare Advantage Logistic regression Article 03 medical and health sciences 0302 clinical medicine Opiate Substitution Treatment Medicine Humans 030212 general & internal medicine Aged Quality of Health Care Retrospective Studies Insurance Health business.industry 030503 health policy & services Public Health Environmental and Occupational Health Retrospective cohort study Opioid use disorder Middle Aged medicine.disease Opioid-Related Disorders United States Buprenorphine Analgesics Opioid Emergency medicine Cohort Medicare Part C Female Private Sector 0305 other medical science business Opioid analgesics medicine.drug |
| Zdroj: | Med Care |
| Popis: | AIMS: To characterize quality of buprenorphine care for opioid use disorder by quantifying buprenorphine initiation, engagement, and maintenance for individuals in a large, diverse, real-world cohort in the United States. DESIGN: Retrospective cohort analysis. SETTING: Opioid use disorder treatment in the outpatient setting. PARTICIPANTS: 45,210 commercially insured and Medicare Advantage enrollees 18 years or older in the OptumLabs® Data Warehouse with an index diagnosis of opioid use disorder between 1/1/2018 and 12/31/2018. INTERVENTIONS: Treatment with buprenorphine. MEASUREMENTS: We calculated 6 measures of buprenorphine treatment quality. We conducted survival analyses to characterize treatment duration and logistic regressions to evaluate the association between clinical and sociodemographic characteristics and quality. FINDINGS: Of 45,210 eligible individuals with opioid use disorder, approximately 1 in 10 (n=4,600, 10.2%) initiated buprenorphine within 365 days following diagnosis (Measure #1) and 2,850 individuals (6.3%) initiated buprenorphine within 14 days of diagnosis (Measure #2). Of individuals initiating treatment within 14 days of diagnosis, 1,769 (62.1%) had 2 or more buprenorphine claims within 34 days of initiation (Measure #3). Of the 4,600 individuals who received buprenorphine, 2,300 (50.0%) were maintained in care with 180 days or more of covered buprenorphine treatment during 365 days after diagnosis (Measure #4). Finally, of the 4,600 individuals who received buprenorphine, 2,543 (55.3%) did not fill any other concurrent opioid analgesic (Measure #5) and 2,951 (64.2%) did not fill any concurrent benzodiazepine (Measure #6). Quality was generally lower for individuals with Medicare Advantage compared to commercial coverage and among Hispanic and Black adults compared to white adults. CONCLUSIONS: Widespread gaps exist in quality of buprenorphine treatment initiation, engagement, and maintenance among commercially insured and Medicare Advantage enrollees with opioid use disorder. |
| Databáze: | OpenAIRE |
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