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美国宽带接入和远程医疗在阿片类药物使用障碍治疗中的应用。

Broadband access and telemedicine adoption for opioid use disorder treatment in the United States.

机构信息

Office of the Assistant Secretary for Planning & Evaluation, US Department of Health & Human Services, Washington, DC, USA.

出版信息

J Rural Health. 2023 Jan;39(1):233-239. doi: 10.1111/jrh.12699. Epub 2022 Jul 15.

Abstract

PURPOSE

Buprenorphine utilization remains low in the United States. Telemedicine guidelines and flexibilities introduced during the COVID-19 pandemic provide an opportunity to increase patient access to buprenorphine. However, it is not known whether Americans without access to buprenorphine waivered provider, especially those residing in rural counties, have sufficient broadband internet access to support telemedicine.

METHODS

Administrative data from the Substance Abuse and Mental Health Services Administration's Buprenorphine Treatment Practitioner Locator Tool and the Fixed Broadband Deployment Data from the Federal Communications Commission are utilized to identify counties with low broadband penetration rate and the number of buprenorphine waivered providers with capacity to accept patients within a 30 miles radius.

FINDINGS

23.9% of the US population does not have access to any buprenorphine waivered provider with a capacity to accept new patients within a 30 miles radius. In counties with low broadband penetration rate, 78.9% of residents does not have access to any buprenorphine waivered provider with patient capacity. In rural counties with low broadband penetration rate, 82.3% of the residents does not have access to any buprenorphine waivered provider with patient capacity within a 30 miles radius.

CONCLUSIONS

Federal policy initiatives are expected to continue the COVID-19-related telehealth flexibilities and to increase the number of providers available to prescribe buprenorphine, but for that to translate into more patients utilizing treatment via telemedicine, high-speed internet access will be essential. This is particularly salient for residents in rural counties where access to both buprenorphine providers and high-speed internet access is limited.

摘要

目的

在美国,丁丙诺啡的使用率仍然很低。在 COVID-19 大流行期间引入的远程医疗指南和灵活性为增加患者获得丁丙诺啡的机会提供了机会。然而,尚不清楚是否有无资格获得丁丙诺啡豁免的医疗提供者的美国人,特别是居住在农村县的美国人,是否有足够的宽带互联网接入来支持远程医疗。

方法

利用美国物质滥用和心理健康服务管理局的丁丙诺啡治疗从业者定位工具中的行政数据和联邦通信委员会的固定宽带部署数据,确定宽带普及率低的县以及在 30 英里半径内有能力接纳患者的丁丙诺啡豁免提供者的数量。

发现

美国 23.9%的人口无法获得任何有能力在 30 英里半径内接纳新患者的丁丙诺啡豁免提供者。在宽带普及率低的县,78.9%的居民无法获得任何有能力接纳患者的丁丙诺啡豁免提供者。在宽带普及率低的农村县,82.3%的居民无法获得任何有能力在 30 英里半径内接纳患者的丁丙诺啡豁免提供者。

结论

预计联邦政策举措将继续推行与 COVID-19 相关的远程医疗灵活性,并增加可开处丁丙诺啡的提供者数量,但要将这转化为更多患者通过远程医疗接受治疗,高速互联网接入将是必不可少的。对于那些既难以获得丁丙诺啡提供者,又难以获得高速互联网接入的农村县的居民来说,这一点尤其重要。

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