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因过量用药而到急诊就诊的医疗补助计划患者:阿片类物质使用障碍药物治疗起始方面的差异

Medicaid Patients With ED Visits For Overdose: Disparities In Initiation Of Medications For Opioid Use Disorder.

作者信息

Nguyen Thuy, Jiao Yang, Lee Stephanie S, Lagisetty Pooja, Bohnert Amy, Kocher Keith E, Chua Kao-Ping

机构信息

Thuy Nguyen (

Yang Jiao, University of Michigan.

出版信息

Health Aff (Millwood). 2025 May;44(5):622-630. doi: 10.1377/hlthaff.2024.00984.

Abstract

Medications for opioid use disorder (MOUD) after emergency department (ED) visits for overdose can reduce subsequent overdose deaths, but disparities in receiving MOUD persist in the US. Using national Medicaid claims data from the period 2016-20, we examined racial and ethnic disparities in MOUD initiation after ED visits for opioid overdose. Overall, 6.4 percent of Medicaid ED visits were associated with a claim for MOUD within thirty days. This rate was highest among non-Hispanic White (7.3 percent) patients and lowest among non-Hispanic Black (4.3 percent) and Hispanic (4.9 percent) patients. The adjusted rate of MOUD initiation was 2.5 percentage points lower among Black patients compared with White patients, and this disparity increased nearly twofold between 2016 and 2020. Although policy and clinical efforts to increase MOUD use in the Medicaid population are important, findings suggest that efforts targeting patients from racial and ethnic minority groups may be warranted.

摘要

在急诊科因过量用药就诊后使用阿片类物质使用障碍药物(MOUD)可降低随后的过量用药死亡风险,但在美国,接受MOUD治疗方面的差异仍然存在。利用2016 - 2020年期间的全国医疗补助索赔数据,我们研究了因阿片类药物过量在急诊科就诊后开始使用MOUD的种族和民族差异。总体而言,6.4%的医疗补助急诊科就诊与30天内MOUD索赔相关。这一比例在非西班牙裔白人患者中最高(7.3%),在非西班牙裔黑人患者(4.3%)和西班牙裔患者(4.9%)中最低。与白人患者相比,黑人患者开始使用MOUD的调整后比例低2.5个百分点,且这一差异在2016年至2020年间增加了近两倍。尽管在医疗补助人群中增加MOUD使用的政策和临床努力很重要,但研究结果表明,针对少数种族和族裔群体患者的努力可能是必要的。

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