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2018年至2022年门诊物质使用治疗设施内综合服务的可及性趋势。

Trends in the availability of comprehensive services within outpatient substance use treatment facilities from 2018 to 2022.

作者信息

Lindenfeld Zoe, Cantor Jonathan H, Chang Ji E

机构信息

Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA.

RAND Corporation, Santa Monica, CA, USA.

出版信息

Am J Drug Alcohol Abuse. 2024 Sep 2;50(5):715-726. doi: 10.1080/00952990.2024.2370462. Epub 2024 Jul 30.

Abstract

Little is known regarding the extent to which substance use disorder (SUD) treatment facilities adopt comprehensive services to meet patients' medical and social needs. To examine trends in the availability of comprehensive services within outpatient SUD treatment facilities from 2018 to 2022. We used data from the Mental Health and Addiction Treatment Tracking Repository, a national database of SUD treatment facilities ( = 13,793). We examined the availability of four domains of comprehensive services and four types of SUD treatment services from 2018 to 2022. We conducted bivariate and multivariate logistic regression predicting the availability of a comprehensive service model (defined as having at least one service from each service domain), controlling for organizational and community characteristics. Comprehensive services were increasingly offered from 2018 to 2022. In unadjusted and adjusted models, facilities which were externally accredited (OR: 1.50; 95%CI: 1.30-1.74), accepted Medicaid (OR: 1.51; 95%CI: 1.30-1.74), performed community outreach (OR: 2.05; 95%CI: 1.80-2.33), provided naloxone and overdose education (OR: 3.50; 95%CI: 3.06-3.99), had a robust SUD treatment infrastructure (OR: 2.33; 95%CI; 2.08-2.62), and were located in a county with a lower percentage of White residents (OR: 0.99; 95%CI: 0.99-0.99), a higher percentage of residents in poverty (OR: 1.02; 95%CI: 1.00-1.03), and the Northeast compared with the South (OR: 1.21; 95%CI: 1.01-1.45), had significantly higher odds of adopting a comprehensive service model. Findings highlight the importance of factors reflecting experience with organizational change efforts and enhanced external support. Policymakers working to enhance the uptake of comprehensive services should focus on obtaining the financial and technical support necessary to develop these models.

摘要

关于物质使用障碍(SUD)治疗机构在多大程度上采用综合服务来满足患者的医疗和社会需求,目前所知甚少。为了研究2018年至2022年门诊SUD治疗机构中综合服务的可获得性趋势。我们使用了心理健康和成瘾治疗跟踪库的数据,这是一个全国性的SUD治疗机构数据库(n = 13,793)。我们研究了2018年至2022年综合服务的四个领域和四种类型的SUD治疗服务的可获得性。我们进行了双变量和多变量逻辑回归,预测综合服务模式的可获得性(定义为每个服务领域至少有一项服务),并控制组织和社区特征。从2018年到2022年,综合服务的提供越来越多。在未调整和调整后的模型中,获得外部认证的机构(OR:1.50;95%CI:1.30 - 1.74)、接受医疗补助的机构(OR:1.51;95%CI:1.30 - 1.74)、开展社区外展活动的机构(OR:2.05;95%CI:1.80 - 2.33)、提供纳洛酮和过量用药教育的机构(OR:3.50;95%CI:3.06 - 3.99)、拥有强大的SUD治疗基础设施的机构(OR:2.33;95%CI;2.08 - 2.62),以及位于白人居民比例较低、贫困居民比例较高的县且位于东北部(与南部相比,OR:1.21;95%CI:1.01 - 1.45)的机构,采用综合服务模式的几率显著更高。研究结果凸显了反映组织变革努力经验和增强外部支持的因素的重要性。致力于提高综合服务采用率的政策制定者应专注于获得开发这些模式所需的财政和技术支持。

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