Cucciare Michael A, Han Xiaotong, Timko Christine, Zaller Nickolas, Kennedy Kristina M, Booth Brenda M
Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA; VA South Central Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR 72205, USA.
Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; VA South Central Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System (CAVHS), North Little Rock, AR 72205, USA.
J Subst Abuse Treat. 2017 Jun;77:6-12. doi: 10.1016/j.jsat.2017.02.017. Epub 2017 Mar 1.
Outpatient medical care (OMC) settings are a care context in which effective management of unhealthy substance use can occur. However, no studies have documented rates of OMC use and characteristics of OMC use among rural substance users. This study sought to examine the rates and frequency of OMC use in a sample of rural drug users over a three-year period. We also explored characteristics of participants associated with use of OMCs over time. Data were collected from June 2005 to September 2007 from a natural history study of 710 stimulant users living in rural communities. Participants were adults, not in drug treatment, and reporting recent methamphetamine, crack cocaine or powder cocaine use. Between 34 and 39% of participants reported any use of an OMC over the three-year follow-up period, with a mean average number of visits ranging from one to two at each follow-up. Having medical insurance, reporting any use of substance use disorder-related care (including formal substance use treatment or mutual-help groups), and higher Addiction Severity Index (ASI) medical and psychiatric composite scores were associated with greater odds of any OMC use and higher frequency of OMC use over time. Being male and having higher ASI alcohol and drug composite scores were associated with lower odds of any OMC use and lower frequency of OMC use. Our findings support the importance of public health efforts to increase OMC use among male rural drug users and those with more severe drug and alcohol use, the important role(s) of Federally Qualified Health Centers and other OMCs in rural communities that serve those with low rates of health insurance, and the need for public health efforts to increase the use of OMCs among rural drug users not experiencing more severe medical or psychiatric health problems.
门诊医疗（OMC）环境是一个能够对不健康物质使用进行有效管理的医疗背景。然而，尚无研究记录农村物质使用者中门诊医疗的使用比例及使用特征。本研究旨在调查三年期间农村吸毒者样本中门诊医疗的使用比例和频率。我们还探讨了随着时间推移与门诊医疗使用相关的参与者特征。数据收集于2005年6月至2007年9月，来自一项对710名居住在农村社区的兴奋剂使用者的自然史研究。参与者为成年人，未接受药物治疗，且报告近期使用过甲基苯丙胺、快克可卡因或粉末可卡因。在三年的随访期内，34%至39%的参与者报告使用过门诊医疗，每次随访的平均就诊次数为一至两次。拥有医疗保险、报告使用过任何与物质使用障碍相关的医疗服务（包括正式的物质使用治疗或互助小组）以及较高的成瘾严重程度指数（ASI）医疗和精神综合评分，与门诊医疗使用的可能性更大以及随着时间推移门诊医疗使用频率更高相关。男性以及较高的ASI酒精和药物综合评分与门诊医疗使用的可能性较低以及门诊医疗使用频率较低相关。我们的研究结果支持了公共卫生努力在增加男性农村吸毒者以及药物和酒精使用更严重者门诊医疗使用方面的重要性，支持了联邦合格健康中心和其他农村社区门诊医疗在为医疗保险覆盖率低的人群提供服务方面的重要作用，以及公共卫生努力在增加未经历更严重医疗或精神健康问题的农村吸毒者门诊医疗使用方面的必要性。
