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探讨提供药物辅助治疗的医生和护士从业者的人口统计学和专业特征:一项回顾性观察研究。

Exploring the Demographic and Professional Characteristics of Physicians and Nurse Practitioners Associated With Providing Medication-Assisted Treatment: A Retrospective Observational Study.

机构信息

Indiana University School of Medicine, Indianapolis, IN, USA.

Indiana University School of Nursing, Indianapolis, IN, USA.

出版信息

Inquiry. 2024 Jan-Dec;61:469580241237144. doi: 10.1177/00469580241237144.

DOI:10.1177/00469580241237144
PMID:38528773
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10964454/
Abstract

Integration of medication-assisted treatment (MAT) for opioid use disorder in primary care settings is an emerging health care delivery model that supports increased access to specialized care but requires primary care provider engagement. Examining the characteristics of providers who provide this service is key to informing targeted recruitment. Using administrative and supplemental data collected during license renewal, this study aimed to identify the characteristics of primary care physicians and nurse practitioners (NPs) associated with greater odds of providing MAT in their practice. A retrospective observational study was conducted using a descriptive correlational design. The analysis included 5259 physicians and 3486 NPs who renewed their licenses electronically in 2021 and specialized in primary care or psychiatry. Chi-square and logistic regression analyses were conducted to identify the demographic and clinical characteristics of physicians and NPs associated with MAT participation in their practice. Physicians had a higher odds ratio (OR) of providing MAT if they were younger than 35 years (OR = 1.334;  = .0443), practiced in a federally qualified health center (OR = 3.101,  < .0001), and offered a sliding fee scale in their practice (OR = 2.046;  < .0001). Likewise, NPs had higher odds of providing MAT if they practiced in a public or community health center (OR = 3.866;  < .0001). The results of this study highlight the personal and professional characteristics of physicians and NPs associated with higher odds of providing MAT. These findings may have implications for the recruitment and sustainability of MAT integration in primary care.

摘要

将药物辅助治疗 (MAT) 整合到初级保健环境中是一种新兴的医疗保健提供模式,支持增加获得专业护理的机会,但需要初级保健提供者的参与。检查提供这种服务的提供者的特征对于有针对性的招聘至关重要。本研究使用在许可证续期期间收集的行政和补充数据,旨在确定与在实践中提供 MAT 的可能性更高相关的初级保健医生和护士从业者 (NP) 的特征。使用描述性相关性设计进行了回顾性观察研究。分析包括 5259 名医生和 3486 名在 2021 年电子续期并专门从事初级保健或精神病学的 NPs。进行了卡方检验和逻辑回归分析,以确定与他们实践中参与 MAT 相关的医生和 NPs 的人口统计学和临床特征。如果医生年龄小于 35 岁(OR=1.334;  = .0443)、在联邦合格的健康中心执业(OR=3.101,  <.0001)且在实践中提供滑动费用表(OR=2.046;  <.0001),则他们提供 MAT 的可能性更高。同样,如果 NPs 在公共或社区卫生中心执业(OR=3.866;  <.0001),则他们提供 MAT 的可能性更高。这项研究的结果强调了与提供 MAT 的可能性更高相关的医生和 NPs 的个人和专业特征。这些发现可能对 MAT 在初级保健中的整合的招聘和可持续性产生影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ac/10964454/4e2223935cdf/10.1177_00469580241237144-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ac/10964454/7b86dbe1c7a5/10.1177_00469580241237144-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ac/10964454/4e2223935cdf/10.1177_00469580241237144-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ac/10964454/7b86dbe1c7a5/10.1177_00469580241237144-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78ac/10964454/4e2223935cdf/10.1177_00469580241237144-fig2.jpg

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本文引用的文献

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Longitudinal assessment of Indiana dentists' participation in Medicaid before and after expansion.印第安纳州牙医在医疗补助计划扩大前后参与情况的纵向评估。
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Launching a Medication-Assisted Treatment in an Outpatient Office-Based Practice.在门诊办公室开展药物辅助治疗。
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Does Provider Gender Affect the Quality of Primary Care?医生的性别会影响初级保健的质量吗?
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U.S. trends in the supply of providers with a waiver to prescribe buprenorphine for opioid use disorder in 2016 and 2018.2016 年和 2018 年美国具有开具丁丙诺啡用于治疗阿片类药物使用障碍处方豁免资质的提供者供应趋势。
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