A Spatial Epidemiologic Analysis of Opioid Use Disorder Treatment in New York State.

IF 3.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Medical Care Pub Date : 2025-05-01 Epub Date: 2025-03-12 DOI:10.1097/MLR.0000000000002142
Ashly E Jordan, Weihui Zhang, Sarah Gorry, Andrew Heck, Constance Burke, Chinazo O Cunningham
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引用次数: 0

Abstract

Background: Opioid agonist treatments (OAT; methadone and buprenorphine) for opioid use disorder (OUD) reduce overdose death by more than 50%. Low population-level rates of OAT are missed opportunities to reduce OUD-related mortality.

Objective: We examined county-level OAT utilization patterns to guide state-level and county-level initiatives to improve equitable access and utilization in New York State (NYS).

Research design: We calculated NYS county-level methadone and buprenorphine population utilization rates per 100,000 residents by county of patient residence using NYS Office of Addiction Services and Supports and public access datasets.

Measures: We mapped rates onto counties and conducted analyses to assess if utilization varied by county, and to identify areas of high utilization (hot spots) and low utilization (cold spots). We used t tests and Fisher exact tests to compare county-level factors.

Results: County-level buprenorphine and methadone utilization rates were 673.76 and 132.19 per 100,000 residents, respectively. Buprenorphine hot spot counties had significantly lower proportions of unemployed (-1.4, P- value<0.01), and higher proportions of non-Hispanic white residents (+50.1, P value<0.01) than counties identified as buprenorphine cold spots. Methadone hot spot counties had significantly higher proportions of unemployed (+1.0, P- value<0.01) and lower proportions of non-Hispanic white residents (-48.1, P- value<0.01) than counties identified as methadonecold spots. All buprenorphine cold spot counties were methadone hot spot counties.

Conclusions: We found that OAT utilization rates differed by race/ethnicity and socioeconomic factors at the county level consistent with national and other state-level findings. Ensuring equitable OAT access must be part of a coordinated response to address the overdose crisis.

纽约州阿片类药物使用障碍治疗的空间流行病学分析。
背景:阿片激动剂治疗(OAT;美沙酮和丁丙诺啡)治疗阿片类药物使用障碍(OUD)可使过量死亡人数减少50%以上。低人群水平的OAT率错失了降低oud相关死亡率的机会。目的:我们研究了县级OAT利用模式,以指导纽约州(NYS)的州和县一级举措,以提高公平获取和利用。研究设计:我们使用纽约州成瘾服务和支持办公室和公共访问数据集计算纽约州每10万居民中县级美沙酮和丁丙诺啡人口使用率。措施:我们绘制了各县的费率图,并进行了分析,以评估各县的利用率是否不同,并确定了高利用率(热点)和低利用率(冷点)的区域。我们使用t检验和Fisher精确检验来比较县级因素。结果:县级丁丙诺啡和美沙酮使用率分别为673.76 / 10万居民和132.19 / 10万居民。丁丙诺啡热点县的失业比例显著低于其他县(-1.4,p值)。结论:我们发现OAT利用率在县一级因种族/民族和社会经济因素而存在差异,这与全国和其他州一级的研究结果一致。确保公平获得OAT必须成为解决过量危机的协调应对措施的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medical Care
Medical Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.20
自引率
3.30%
发文量
228
审稿时长
3-8 weeks
期刊介绍: Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.
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