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在一个全州范围的惩教系统中,接受阿片类物质使用障碍药物治疗后卫生服务利用情况的变化

Changes In Health Services Use After Receipt Of Medications For Opioid Use Disorder In A Statewide Correctional System.

作者信息

Howell Benjamin A, Martin Rosemarie A, Lebeau Rebecca, Truong Ashley Q, Wang Emily A, Rich Josiah D, Clarke Jennifer G

机构信息

Benjamin A. Howell (

Rosemarie A. Martin is an associate professor in the Department of Behavioral and Social Sciences, Brown University School of Public Health, in Providence, Rhode Island.

出版信息

Health Aff (Millwood). 2021 Aug;40(8):1304-1311. doi: 10.1377/hlthaff.2020.02156.

Abstract

To decrease opioid overdose mortality, prisons and jails in the US are increasingly offering medications for opioid use disorder (OUD) to incarcerated people. It is unknown how receipt of these medications in a correctional setting affects health services use after release. In this article we analyze changes in postrelease health care use after the implementation of a statewide medications for OUD program in the unified jail and prison system of the Rhode Island Department of Corrections. Using Medicaid claims data, we examined individual health care use in the community before and after receipt of medications for OUD while incarcerated. We found that inpatient admissions did not change, emergency department visits decreased, and both nonacute outpatient services and pharmacy claims increased after people received medications for OUD while incarcerated. There was no change in total health care costs paid by Medicaid. Our findings provide evidence that people's use of health care services paid for by Medicaid did not increase after they started medications for OUD in correctional settings. Given the frequent interaction of people with OUD with the criminal justice system, offering evidence-based treatment of OUD in correctional settings is an important opportunity to initiate addiction treatment.

摘要

为降低阿片类药物过量致死率,美国的监狱正越来越多地为被监禁者提供治疗阿片类药物使用障碍(OUD)的药物。在惩教环境中接受这些药物如何影响释放后的医疗服务使用情况尚不清楚。在本文中,我们分析了罗德岛惩教部统一监狱系统中实施全州范围的OUD药物项目后释放后医疗保健使用情况的变化。利用医疗补助索赔数据,我们研究了被监禁者在接受OUD药物治疗前后在社区中的个人医疗保健使用情况。我们发现,住院人数没有变化,急诊就诊次数减少,被监禁者接受OUD药物治疗后,非急性门诊服务和药房索赔均增加。医疗补助支付的总医疗费用没有变化。我们的研究结果表明,在惩教环境中开始接受OUD药物治疗后,人们使用由医疗补助支付的医疗服务并没有增加。鉴于患有OUD的人与刑事司法系统的频繁互动,在惩教环境中提供基于证据的OUD治疗是启动成瘾治疗的重要契机。

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