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高与低新冠社交距离县的物质使用障碍治疗设施的远程医疗能力。

Telehealth Capability Among Substance Use Disorder Treatment Facilities in Counties With High Versus Low COVID-19 Social Distancing.

机构信息

RAND Corporation, Santa Monica, CA (JC), RAND Corporation, Pittsburgh, PA (BDS), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (BS).

出版信息

J Addict Med. 2020 Dec;14(6):e366-e368. doi: 10.1097/ADM.0000000000000744.

Abstract

OBJECTIVE

To quantify the availability of telehealth services at substance use treatment facilities in the U.S. at the beginning of the COVID-19 pandemic, and determine whether telehealth is available at facilities in counties with the greatest amount of social distancing.

METHODS

We merged county-level measures of social distancing through April 18, 2020 to detailed administrative data on substance use treatment facilities. We then calculated the number and share of treatment facilities that offered telehealth services by whether residents of the county social distanced or not. Finally, we estimated a logistic regression that predicted the offering of telehealth services using both county- and facility-level characteristics.

RESULTS

Approximately 27% of substance use facilities in the U.S. reported telehealth availability at the outset of the pandemic. Treatment facilities in counties with a greater social distancing were less likely to possess telemedicine capability. Similarly, nonopioid treatment programs that offered buprenorphine or vivitrol in counties with a greater burden of COVID-19 were less likely to offer telemedicine when compared to similar facilities in counties with a lower burden of COVID-19.

CONCLUSIONS

Relatively few substance use treatment facilities offered telehealth services at the onset of the COVID-19 pandemic. Policymakers and public health officials should do more to support facilities in offering telehealth services.

摘要

目的

在 COVID-19 大流行初期量化美国物质使用治疗设施提供远程医疗服务的情况,并确定在社交距离最大的县的治疗设施是否提供远程医疗服务。

方法

我们将截至 2020 年 4 月 18 日的县级社交距离措施与物质使用治疗设施的详细行政数据合并。然后,我们计算了提供远程医疗服务的治疗设施数量和比例,方法是根据该县居民是否保持社交距离。最后,我们使用县和设施层面的特征进行了逻辑回归分析,预测远程医疗服务的提供情况。

结果

美国约有 27%的物质使用设施在大流行初期报告提供远程医疗服务。社交距离较大的县的治疗设施不太可能具备远程医疗能力。同样,在 COVID-19 负担较重的县,提供丁丙诺啡或维维酮的非阿片类治疗计划与 COVID-19 负担较低的县的类似设施相比,提供远程医疗的可能性较低。

结论

在 COVID-19 大流行初期,相对较少的物质使用治疗设施提供远程医疗服务。政策制定者和公共卫生官员应做更多工作,支持设施提供远程医疗服务。

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