Evaluating the Impact of Low Threshold Bridge Clinic Expansion on Equitable Access to Substance Use Disorder Treatment.

Abstract

Objectives: Racial inequities in substance use disorder treatment, and specifically buprenorphine treatment, contribute to overdose inequities. Bridge Clinics are a low-threshold, transitional treatment model that may improve treatment access. This report assesses the change in visit volume for Black and Hispanic patients and those with limited English proficiency (LEP) after the implementation of the Bridge Clinic expansion across 4 distinct sites.

Methods: Between October 2021 and 2023, 3 hospital-based Bridge Clinics were expanded, and a community-based Bridge Clinic was established, all in regions with high racial and language inequities in overdose mortality. Implementation included creating Bridge Clinic performance measures, which were reviewed with clinic leadership monthly, developing a toolkit, and launching mobile services. We present Bridge Clinic visit volume aggregated by calendar year for Black-non Hispanic, Hispanic (any race), and LEP patients. We calculated the percent of total visits for each patient group and assessed the change over time.

Results: Comparing 2021 to 2023, total visits increased from 5323 to 10,350, and unique patients increased from 1893 to 3316. Annual visits increased from 437 to 1151 visits for Black patients; 566 to 1609 for Hispanic patients; and 96 to 265 for LEP patients. The percent of visits grew significantly for Black (8.21% vs. 10.24%, P<0.001), Hispanic (10.63% vs. 15.55%, P<0.001) and LEP patients (1.80% vs. 2.56%, P=0.003) from 2021 to 2023.

Conclusions: Expanding low-barrier Bridge Clinics may increase substance use disorder (SUD) treatment visits for Black and Hispanic patients and those with LEP.