Costs of care for persons with opioid dependence in commercial integrated health systems

Addiction Science & Clinical Practice

Frances L Lynch⁴  Dennis McCarty⁵  Jennifer Mertens¹  Nancy A Perrin⁴  Carla A Green⁴  Sujaya Parthasarathy¹  John F Dickerson⁴  Bradley M Anderson²  David Pating³ 

[1] Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612, USA

[2] Addiction Medicine Department, Kaiser Permanente Northwest, 3550N. Interstate Avenue, Portland, OR 97227, USA

[3] Kaiser Permanente Chemical Dependency Recovery Program, 1201 Fillmore Street, San Francisco, CA 94115, USA

[4] Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR 97227, USA

[5] Department of Public Health & Preventive Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Hill Road, CB 669, Portland, OR 97239, USA

关键词: Parity;    Commercial health insurance;    Health care utilization;    Cost analysis;    Substance abuse;   

Others  :  1082110
DOI  :  10.1186/1940-0640-9-16

 received in 2013-07-25, accepted in 2014-06-24,  发布年份 2014

【 摘 要 】

Background

When used in general medical practices, buprenorphine is an effective treatment for opioid dependence, yet little is known about how use of buprenorphine affects the utilization and cost of health care in commercial health systems.

Methods

The objective of this retrospective cohort study was to examine how buprenorphine affects patterns of medical care, addiction medicine services, and costs from the health system perspective. Individuals with two or more opioid-dependence diagnoses per year, in two large health systems (System A: n = 1836; System B: n = 4204) over the time span 2007–2008 were included. Propensity scores were used to help adjust for group differences.

Results

Patients receiving buprenorphine plus addiction counseling had significantly lower total health care costs than patients with little or no addiction treatment (mean health care costs with buprenorphine treatment = $13,578; vs. mean health care costs with no addiction treatment = $31,055; p < .0001), while those receiving buprenorphine plus addiction counseling and those with addiction counseling only did not differ significantly in total health care costs (mean costs with counseling only: $17,017; p = .5897). In comparison to patients receiving buprenorphine plus counseling, those with little or no addiction treatment had significantly greater use of primary care (p < .001), other medical visits (p = .001), and emergency services (p = .020). Patients with counseling only (compared to patients with buprenorphine plus counseling) used less inpatient detoxification (p < .001), and had significantly more PC visits (p = .001), other medical visits (p = .005), and mental health visits (p = .002).

Conclusions

Buprenorphine is a viable alternative to other treatment approaches for opioid dependence in commercial integrated health systems, with total costs of health care similar to abstinence-based counseling. Patients with buprenorphine plus counseling had reduced use of general medical services compared to the alternatives.

【 授权许可】

   
2014 Lynch et al.; licensee BioMed Central Ltd.

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