在参加医疗补助计划的青少年中，物质使用障碍治疗开始和参与的预测因素

IF 2.8 3区医学 Q2 SUBSTANCE ABUSE

Substance abuse Pub Date : 2022-06-07 DOI:10.1080/08897077.2022.2074603

L. Chavez, D. Steelesmith, J. Bridge, C. Fontanella

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引用次数: 1

摘要

背景:青少年物质使用障碍(SUD)应及时获得治疗，以改善终身预后。医疗保健有效性数据和信息集(HEDIS)启动和参与治疗(IET)绩效测量旨在促进SUD患者的质量改善。然而，很少有研究评估了青少年或其他心理健康服务参与者的测量表现的预测因素，这对于理解治疗质量的差异或有针对性的改进策略的机会至关重要。本研究报告了患有SUD的青少年中IET的比率和预测因素，以及接受任何心理健康服务的情况。方法:样本包括在14个州参加医疗补助计划的青少年，他们有合格的SUD诊断(2009-2013)，并符合HEDIS IET绩效测量资格标准。评估了三个结果，包括在合格诊断的14天内开始SUD治疗，在开始治疗的30天内参与SUD治疗(2次或以上)，以及在开始治疗的30天内接受任何心理健康服务(1次或以上)。使用逻辑回归来确定与结果相关的人口学和临床特征。结果:在符合条件的20602名青少年中，49.5%的人开始了SUD治疗，48.5%的人接受了SUD治疗，70%的人接受了任何心理健康服务。临床需求水平较高的青少年(例如，医疗复杂性、精神健康合并症和多重SUD诊断)启动治疗的几率显著较高，但参与治疗或接受任何精神卫生服务的几率较低。结论:为了增加SUD治疗的提供，应针对同时存在心理健康需求的青少年，其中许多人在SUD诊断后正在接受心理健康服务。整合成瘾和心理健康服务可以解决这些错失的机会。

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Predictors of Substance Use Disorder Treatment Initiation and Engagement among Adolescents Enrolled in Medicaid

Background: Adolescents with substance use disorders (SUD) should receive timely access to treatment to improve lifelong outcomes. The Healthcare Effectiveness Data and Information Set (HEDIS) initiation and engagement in treatment (IET) performance measure was intended to promote quality improvement for patients with SUD. Yet, few studies have assessed predictors of measure performance among adolescents or other engagement in mental health services, which is critical to understanding disparities in treatment quality or opportunities for targeted improvement strategies. The present study reports the rates and predictors of IET among adolescents with SUD, as well as receipt of any mental health services. Methods: The sample included adolescents enrolled in Medicaid in 14 states who had a qualifying diagnosis for SUD (2009–2013) and met HEDIS IET performance measure eligibility criteria. Three outcomes were assessed, including initiation of SUD treatment within 14 days of qualifying diagnosis, engagement in SUD treatment (2 or more encounters) within 30 days of initiation, and receipt of any mental health services (1 or more encounters) within 30 days of initiation. Logistic regression was used to identify demographic and clinical characteristics associated with outcomes. Results: Among 20,602 adolescents who met eligibility criteria, 49.5% initiated SUD treatment, 48.5% engaged in SUD treatment, and 70% received any mental health service. Adolescents with higher levels of clinical need (e.g., medical complexity, mental health comorbidity, and multiple SUD diagnoses) had significantly higher odds of initiating, but lower odds of engaging in treatment or receiving any mental health service. Conclusions: To increase the delivery of SUD treatment, efforts should target adolescents with co-occurring mental health needs, many of whom are receiving mental health services after SUD diagnosis. Integrating addiction and mental health services could address these missed opportunities.

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来源期刊

Substance abuse SUBSTANCE ABUSE-

CiteScore

5.90

自引率

2.90%

发文量

审稿时长

>12 weeks

期刊介绍： Now in its 4th decade of publication, Substance Abuse journal is a peer-reviewed journal that serves as the official publication of Association for Medical Education and Research in Substance Abuse (AMERSA) in association with The International Society of Addiction Medicine (ISAM) and the International Coalition for Addiction Studies in Education (INCASE). Substance Abuse journal offers wide-ranging coverage for healthcare professionals, addiction specialists and others engaged in research, education, clinical care, and service delivery and evaluation. It features articles on a variety of topics, including: Interdisciplinary addiction research, education, and treatment Clinical trial, epidemiology, health services, and translation addiction research Implementation science related to addiction Innovations and subsequent outcomes in addiction education Addiction policy and opinion International addiction topics Clinical care regarding addictions.