Racial Disparities in Payment Source of Opioid Use Disorder Treatment among Non-Incarcerated Justice-Involved Adults in the United States.

IF 1.6 4区 医学 Q4 HEALTH POLICY & SERVICES
Maria X Sanmartin, Ryan M McKenna, Mir M Ali, Jean D Krebs
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引用次数: 0

Abstract

Background: Research has documented a low rate of opioid use disorder (OUD) treatment utilization among individuals involved in the criminal justice system. However, racial disparities in sources of payment for OUD treatment have not been examined in the existing literature.

Aim of the study: Although substance use disorder (SUD) treatment is relatively rare for all criminal justice system involved racial-groups, previous research has indicated that, among individuals with SUD, members of racial minority groups receive treatment at lower rates than their non-Hispanic White counterparts. Given the alarming rise of OUD in the US and the association between source of payment and utilization of health care services, this study seeks to quantify racial disparities in sources of payment for OUD treatment among individuals with criminal justice involvement.

Method: Using data from the 2008-2016 National Survey of Drug Use and Health (NSDUH), this study analyzes data on non-incarcerated individuals with OUD who have had any criminal justice involvement in the previous 12 months. An extension of the Blinder-Oaxaca decomposition method for non-linear models is implemented to determine the extent that differences in OUD treatment utilization across non-Hispanic Blacks and non-Hispanic Whites are explained by observed and measurable characteristics and/or unobserved factors.

Results: Results indicate that non-Hispanic Whites are more likely to have their OUD treatment paid by a court (10%) relative to non-Hispanic Blacks (4.0%). Black-White differences in measurable factors explain 87% of the disparity, while the rest is attributed to unobserved factors. Non-Hispanic Blacks are more likely to have their OUD treatment paid by public insurance (77% vs 36%) than non-Hispanic Whites and only 72% of this disparity can be explained by observed characteristics.

Implications for health care provision and use: Our findings indicate racial disparities in sources of payment for OUD treatment among the criminal justice-involved population. Expansion of health insurance coverage and access to substance use disorder treatments would be beneficial for reducing health care disparities.

Implications for health policy: Equitable treatment options in the criminal justice system that incentivize OUD treatment availability may help address racial disparities in sources of payment among the criminal justice-involved population with OUD.

Implications for further research: Future research should focus on understanding the main factors driving the court's treatment decisions among the criminal justice system involved individuals.

美国非监禁司法参与成年人阿片类药物使用障碍治疗支付来源的种族差异
背景:研究表明,参与刑事司法系统的个人中阿片类药物使用障碍(OUD)治疗利用率较低。然而,在现有文献中,OUD治疗的支付来源中的种族差异尚未得到研究。研究目的:虽然物质使用障碍(SUD)治疗在所有涉及种族群体的刑事司法系统中相对罕见,但先前的研究表明,在患有SUD的个体中,少数种族群体的成员接受治疗的比例低于非西班牙裔白人。鉴于美国OUD的惊人增长以及支付来源与卫生保健服务利用之间的关联,本研究试图量化涉及刑事司法的个体中OUD治疗支付来源的种族差异。方法:利用2008-2016年全国药物使用与健康调查(NSDUH)的数据,本研究分析了过去12个月内有任何刑事司法参与的非监禁OUD患者的数据。对非线性模型的Blinder-Oaxaca分解方法进行了扩展,以确定非西班牙裔黑人和非西班牙裔白人之间OUD治疗利用差异的程度是由观察到的和可测量的特征和/或未观察到的因素来解释的。结果:结果表明,非西班牙裔白人(10%)比非西班牙裔黑人(4.0%)更有可能获得法院支付的OUD治疗费用。黑人和白人在可测量因素上的差异解释了87%的差异,而其余的则归因于不可观察的因素。非西班牙裔黑人比非西班牙裔白人更有可能获得公共保险支付的OUD治疗(77%对36%),这种差异只有72%可以用观察到的特征来解释。对卫生保健提供和使用的影响:我们的研究结果表明,在涉及刑事司法的人群中,OUD治疗的支付来源存在种族差异。扩大医疗保险覆盖面和获得药物使用障碍治疗将有利于缩小保健差距。对卫生政策的影响:刑事司法系统中鼓励OUD治疗的公平治疗方案可能有助于解决涉及刑事司法的OUD患者在支付来源方面的种族差异。对进一步研究的启示:未来的研究应侧重于了解推动法院在刑事司法系统中涉及个人的处理决定的主要因素。
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来源期刊
CiteScore
2.20
自引率
6.20%
发文量
8
期刊介绍: The Journal of Mental Health Policy and Economics publishes high quality empirical, analytical and methodologic papers focusing on the application of health and economic research and policy analysis in mental health. It offers an international forum to enable the different participants in mental health policy and economics - psychiatrists involved in research and care and other mental health workers, health services researchers, health economists, policy makers, public and private health providers, advocacy groups, and the pharmaceutical industry - to share common information in a common language.
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