School of Medicine, China Medical University, Taichung, Taiwan.
Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan.
Adv Ther. 2021 Jun;38(6):2908-2919. doi: 10.1007/s12325-021-01633-w. Epub 2021 Feb 8.
The health benefits of entering methadone maintenance treatment (MMT) for opioid-dependent persons may not be merely limited to therapy of opioid use disorder. We aimed to compare the healthcare utilization of MMT patients before and after MMT.
A retrospective analysis was performed using the Taiwan Illicit Drug Issue Database and the National Health Insurance Research Database (NHIRD) between 2014 and 2016. We included 1255 newly enrolled MMT patients in 2015 and randomly selected 5020 patients from NHIRD matched by age and gender as the comparison group. Changes in healthcare utilization 1 year before and 1 year after the date of the index date (MMT initiation) were compared within and between MMT and comparison groups.
During the 1-year period following MMT, the hospitalization length was considerably decreased, while the number of outpatient visits, emergency department (ED) visits, and ED expenditure significantly increased in MMT patients. Multivariable linear regression with the difference-in-difference approach revealed that all the categories of healthcare utilization increased, except for a minor increase of outpatient expenditure and a slight decrease of hospitalization length for the MMT group relative to the comparison group. Increases in utilization of the departments of psychiatry and infectious diseases of the MMT patients were considerable.
MMT is associated with increased healthcare utilization, and departments of psychiatry and infectious diseases play substantial roles. Policy-makers should warrant access for all who need healthcare by ensuring the availability of the treatment for drug dependence.
进入美沙酮维持治疗(MMT)可能不仅有益于治疗阿片类药物依赖者,还有益于他们的健康。我们旨在比较 MMT 患者在 MMT 前后的医疗保健利用情况。
2014 年至 2016 年,我们使用台湾非法药物问题数据库和全民健康保险研究数据库(NHIRD)进行了回顾性分析。我们纳入了 2015 年新入组的 1255 名 MMT 患者,并随机选择了与年龄和性别相匹配的 5020 名 NHIRD 患者作为对照组。在 MMT 组和对照组中,比较了在索引日期(MMT 开始)前 1 年和后 1 年的医疗保健利用变化。
在 MMT 后的 1 年期间,MT 患者的住院时间明显缩短,而门诊就诊次数、急诊就诊次数和急诊支出显著增加。差异中差异法的多变量线性回归显示,除 MMT 组门诊支出略有增加和住院时间略有减少外,所有类别的医疗保健利用均增加。MMT 患者的精神科和传染病科的利用增加相当可观。
MMT 与医疗保健利用的增加有关,精神科和传染病科发挥了重要作用。政策制定者应通过确保提供治疗药物依赖的方法来确保所有需要医疗保健的人都能获得医疗保健。