Nahian Ahmed, McFadden Lisa M
College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine at Seton Hill, Lynch Hall, 20 Seton Hill Dr, Greensburg, PA 15601, USA.
Division of Basic Biomedical Sciences, University of South Dakota, 414 E. Clarke St., Vermillion, SD 57069, USA.
Healthcare (Basel). 2024 Aug 16;12(16):1630. doi: 10.3390/healthcare12161630.
As drug overdose mortality rises in the United States, healthcare visits present critical opportunities to mitigate this trend. This study examines changes in healthcare visits for substance use disorders (SUDs) and remission prior to and during the COVID-19 pandemic in the Great Plains, with a focus on identifying the characteristics of those served. Data were analyzed from 109,671 patient visits (mode = one visit per patient), encompassing diverse demographics, including sex, age, race, ethnicity, and geographic location. Visits analyzed included those for Alcohol Use Disorder (AUD), Opioid Use Disorder (OUD), or Stimulant Use Disorder (StUD) and those in remission of these disorders between March 2019 and March 2021. Patient demographic information and geographic factors, like rurality and Medicaid expansion status, were considered, and logistic regression was utilized. Visits were primarily by White (70.83%) and Native American (21.39%) patients, non-Hispanic (91.70%) patients, and males (54.16%). Various demographic, geographic, and temporal trends were observed. Findings indicated that males were more likely to receive an AUD diagnosis, while females were more likely to receive an OUD or StUD diagnosis. Metropolitan-residing patients were more likely to receive an AUD diagnosis, while non-metropolitan patients were more likely to receive an OUD diagnosis. Remission odds increased for StUD during the pandemic but decreased for AUD and OUD. These findings illuminate the demographic and geographic patterns of SUD-related healthcare visits, suggesting critical touchpoints for intervention. The results emphasize the urgent need for targeted healthcare strategies, especially in rural and underserved areas, to address persistent health disparities.
随着美国药物过量死亡率上升，医疗就诊为缓解这一趋势提供了关键契机。本研究考察了大平原地区在2019冠状病毒病大流行之前及期间物质使用障碍（SUD）的医疗就诊及缓解情况变化，重点是确定接受治疗者的特征。分析了来自109,671次患者就诊的数据（模式为每位患者就诊一次），涵盖了包括性别、年龄、种族、族裔和地理位置在内的不同人口统计学特征。分析的就诊包括酒精使用障碍（AUD）、阿片类物质使用障碍（OUD）或兴奋剂使用障碍（StUD）的就诊以及2019年3月至2021年3月期间这些障碍缓解期的就诊。考虑了患者人口统计学信息和农村地区及医疗补助扩大状况等地理因素，并采用了逻辑回归分析。就诊患者主要是白人（70.83%）和美国原住民（21.39%）、非西班牙裔（91.70%）患者以及男性（54.16%）。观察到了各种人口统计学、地理和时间趋势。研究结果表明，男性更有可能被诊断为AUD，而女性更有可能被诊断为OUD或StUD。居住在大都市的患者更有可能被诊断为AUD，而非大都市患者更有可能被诊断为OUD。在大流行期间，StUD的缓解几率增加，但AUD和OUD的缓解几率下降。这些发现揭示了与SUD相关的医疗就诊的人口统计学和地理模式，表明了关键的干预接触点。结果强调迫切需要有针对性的医疗策略，特别是在农村和服务不足地区，以解决持续存在的健康差距问题。
