Rural-urban differences in out-of-network treatment initiation and engagement rates for substance use disorders.
Health Serv Res
; 59(5): e14299, 2024 10.
Article
em En
| MEDLINE
| ID: mdl-38456488
ABSTRACT
OBJECTIVE:
To examine rural-urban disparities in substance use disorder treatment access and continuation. DATA SOURCES AND STUDYSETTING:
We analyzed a 2016-2018 U.S. national secondary dataset of commercial insurance claims. STUDYDESIGN:
This cross-sectional study examined individuals with a new episode of opioid, alcohol, or other drug use disorders. Treatment initiation and engagement rates, and rates of using out-of-network providers for these services, were compared between rural and urban patients. DATA COLLECTION We included individuals 18-64 years old with continuous employer-sponsored insurance. PRINCIPALFINDINGS:
Patients in rural settings experienced lower treatment initiation rates for alcohol (36.6% vs. 38.0%, p < 0.001), opioid (41.2% vs. 44.2%, p < 0.001), and other drug (37.7% vs. 40.1%, p < 0.001) use disorders, relative to those in urban areas. Similarly, rural patients had lower treatment engagement rates for alcohol (15.1% vs. 17.3%, p < 0.001), opioid (21.0% vs. 22.6%, p < 0.001), and other drug (15.5% vs. 17.5%, p < 0.001) use disorders. Rural patients had higher out-of-network rates for treatment initiation for other drug use disorders (20.4% vs. 17.2%, p < 0.001), and for treatment engagement for alcohol (27.6% vs. 25.2%, p = 0.006) and other drug (36.1% vs. 31.1%, p < 0.001) use disorders.CONCLUSIONS:
These findings indicate that individuals with substance use disorders in rural areas have lower rates of initial and ongoing treatment, and are more likely to seek care out-of-network.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
População Rural
/
População Urbana
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Transtornos Relacionados ao Uso de Substâncias
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Acessibilidade aos Serviços de Saúde
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article