Spatial accessibility of substance use disorder treatment programs, compared with other health care facilities, in New York State, 2024.

IF 3.2 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2025-07-31 DOI:10.1186/s13722-025-00592-9

Marcus A Bachhuber, Chinazo O Cunningham, Pat Lincourt, Ashly E Jordan

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引用次数: 0

Abstract

Background: Spatial accessibility of substance use disorder (SUD) treatment is a crucial component of access and a comprehensive analysis can help to identify if and where a lack of spatial accessibility is a barrier to treatment.

Methods: We conducted a cross-sectional analysis of spatial accessibility of SUD treatment (outpatient, opioid treatment program, and residential) in New York State (NYS). We estimated two measures of spatial accessibility: one-way travel time (i.e., drive time for NYS outside of New York City [NYC] and public transit time for NYC) and robustness (i.e., the difference in travel time between the closest and fifth closest facility). Comparison facilities included Federally Qualified Health Centers, dialysis facilities, and hospitals. We compared travel time and robustness by urbanicity (NYC, urban non-NYC, rural) and NYS economic development region using population-weighted paired t-tests.

Results: The percentage of NYS residents within 30 min travel time was 97.2% for outpatient SUD treatment programs and 82.3% for opioid treatment programs. Mean statewide travel time to outpatient SUD treatment programs was comparable to travel time to Federally Qualified Health Centers (difference: 1.0 min [95%CI 0.9 to 1.1; P < 0.001]) and dialysis facilities (difference: 0.1 min [95%CI 0.03 to 0.2; P = 0.01]), and significantly shorter than to hospitals (difference: 5.6 min [95%CI 5.4 to 5.7; P < 0.001]). Travel time to opioid treatment programs was significantly longer than to Federally Qualified Health Centers (difference: -7.4 min [95%CI - 7.6 to - 7.2; P < 0.001]), dialysis facilities (difference: -8.2 min [95%CI - 8.4 to - 8.1; P < 0.001]), and hospitals (difference: - 2.8 min [95%CI - 3.0 to - 2.6; P < 0.001]). Compared with NYC, mean travel time to each type of SUD treatment program was significantly shorter in urban non-NYC areas and longer in rural areas. For robustness, compared with NYC, there was no significant difference in urban non-NYC areas for outpatient and residential SUD treatment programs, but more limited robustness for opioid treatment programs in urban non-NYC areas and all types of SUD treatment programs in rural areas.

Conclusion: We identified widespread spatial accessibility of SUD treatment facilities across NYS. Recent opportunities such as revised federal regulations on opioid treatment program mobile medication units, increased flexibility in using telehealth in opioid treatment programs and other settings, and opioid settlement funding can be leveraged to increase access in rural areas.

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2024年，纽约州与其他医疗机构相比，物质使用障碍治疗项目的空间可达性。

背景：物质使用障碍（SUD）治疗的空间可达性是可达性的关键组成部分，综合分析可以帮助确定缺乏空间可达性是否以及在何处成为治疗障碍。方法：我们对纽约州（NYS） SUD治疗（门诊、阿片类药物治疗方案和住宅）的空间可达性进行了横断面分析。我们估计了两种空间可达性度量：单程旅行时间（即纽约人在纽约市以外的开车时间和纽约市的公共交通时间）和鲁棒性（即最近的和第五最近的设施之间的旅行时间差异）。比较设施包括联邦合格医疗中心、透析设施和医院。我们使用人口加权配对t检验比较了城市（纽约市、非纽约市城市、农村）和纽约经济发展区的旅行时间和稳健性。结果：纽约居民在30分钟车程内接受门诊SUD治疗的比例为97.2%，阿片类药物治疗的比例为82.3%。全州范围内到门诊SUD治疗项目的平均旅行时间与到联邦合格医疗中心的旅行时间相当(差异：1.0分钟[95%CI 0.9至1.1；结论：我们确定了整个纽约州SUD处理设施的广泛空间可达性。最近的机会，如修订了关于阿片类药物治疗方案流动医疗单位的联邦条例，在阿片类药物治疗方案和其他环境中使用远程保健的灵活性增加，以及阿片类药物结算资金可用于增加农村地区的可及性。

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

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.