Franz Berkeley, Cronin Cory E, Wainwright Alexandra, Pagán José A
1 Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA.
2 College of Health Sciences & Professions, Ohio University, OH, USA.
J Prim Care Community Health. 2019 Jan-Dec;10:2150132719863611. doi: 10.1177/2150132719863611.
To assess the strategies that nonprofit hospitals are adopting to address opioid abuse after requirements for community engagement expanded in the Affordable Care Act. We constructed a dataset of implementation activities for a 20% random sample of nonprofit hospitals in the United States. Using logistic regression, we assessed the extent to which strategies adopted are new, existing, or primarily partnerships. Using negative binomial regression, we assessed the total number of strategies adopted. We controlled for hospital and community characteristics as well as state policies related to opioid abuse. Most strategies adopted by hospitals were new and clinical in nature and the most common number of strategies adopted was one. Hospitals in the Northeast were more likely to adopt a higher number of strategies and to partner with community-based organizations. Hospitals that partner with community-based organizations were more likely to adopt strategies that engage in harm reduction, targeted risk education, or focus on addressing social determinants of health. Community, institutional, and state policy characteristics predict hospital involvement in addressing opioid abuse. These findings underscore several opportunities to support hospital-led interventions to address opioid abuse.
为评估在《平价医疗法案》中社区参与要求扩大后，非营利性医院为应对阿片类药物滥用而采取的策略。我们构建了一个数据集，该数据集包含美国20%的非营利性医院随机样本的实施活动。使用逻辑回归，我们评估了所采用策略的新、旧程度或主要是合作关系的程度。使用负二项回归，我们评估了所采用策略的总数。我们控制了医院和社区特征以及与阿片类药物滥用相关的州政策。医院采用的大多数策略本质上是新的且属于临床范畴，最常见的策略采用数量为一种。东北部的医院更有可能采用更多数量的策略，并与社区组织合作。与社区组织合作的医院更有可能采用旨在减少伤害、进行有针对性的风险教育或专注于解决健康的社会决定因素的策略。社区、机构和州政策特征可预测医院在应对阿片类药物滥用方面的参与情况。这些发现凸显了支持医院主导的应对阿片类药物滥用干预措施的几个机会。
