Social determinants of health and emergency department utilization among adults receiving buprenorphine for opioid use disorder

Drug and Alcohol Dependence Reports

Brandon Wills¹  Caitlin E. Martin²  Anna Beth Parlier-Ahmad³  Maja Radic⁴ 

[1] Department of Emergency Medicine, Virginia Commonwealth University, 1250 E. Marshall St., Richmond, VA 23298, USA;Department of Obstetrics and Gynecology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, 1250 E. Marshall St., Richmond, VA 23298, USA;Department of Psychology, Virginia Commonwealth University, 806 W. Franklin St., Richmond, VA 23284, USA;Virginia Commonwealth University School of Medicine, 1201 E Marshall St, Richmond, VA 23298, USA;

关键词: Buprenorphine;    Opioid use disorder;    Healthcare utilization;    Emergency department;    Substance use disorder treatment;    Social determinants of health;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Individuals with opioid use disorder (OUD) use the emergency department (ED) at high rates. Medication treatment for OUD (MOUD) is associated with reduced ED utilization. However, individuals receiving MOUD still utilize ED services at higher rates than the general population. The objective of this study is to compare the psychosocial and clinical characteristics of those who do and do not utilize ED services based on the Healthy People 2030 framework regarding social determinants of health (SDoH) among a sample of individuals receiving MOUD. Methods: Participants receiving buprenorphine for OUD at an outpatient addiction clinic completed a cross-sectional survey between July and September 2019. A 6-month prospective medical record review was conducted. The primary outcome was ED visit (yes/no) during the 6-month study period. Demographic, psychosocial, and clinical characteristics were gathered from survey measures and chart abstraction. Chi square and T-tests tested differences by ED utilization. Results: Participants (n=142) were 54.9% female and 68.8% Black, with an average age of 43.2 years (SD=12.5). Of the participants, 38.7% visited the ED in the study period, primarily for infectious or musculoskeletal causes. Participants with an ED visit were more likely to be Black (p=.011), have less social support (p=.030), more medical comorbidities (p=.008) including chronic pain (p=.045), and more visits with an addiction provider in the study period (p=.009). Conclusions: Factors associated with ED utilization among individuals receiving buprenorphine for OUD include low social support and medical comorbidities, including chronic pain. More research is needed on modifiable SDoH that influence ED utilization.

【 授权许可】

Unknown