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The Role of Primary Care in Improving Access to Medication-Assisted Treatment for Rural Medicaid Enrollees with Opioid Use Disorder
- Source :
- J Gen Intern Med
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- 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
- Subjects :
- 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
Subjects
Details
- ISSN :
- 15251497 and 08848734
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Journal of General Internal Medicine
- Accession number :
- edsair.doi.dedup.....c5154ab0acbecd667862229a6864eca8