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Buprenorphine Treatment and Patient Use of Health Services after the Affordable Care Act in an Integrated Health Care System.
J Psychoactive Drugs. 2017 Apr-Jun; 49(2):160-168.JP

Abstract

The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258). Logistic and negative binomial regressions were used to model persistent buprenorphine use, and to examine whether persistent use was related to health services utilization. Buprenorphine patients were largely similar pre- and post-ACA, although more post-ACA patients had a marijuana use disorder (p < .01). Post-ACA patients were more likely to have high-deductible benefit plans (p < .01). Use of psychiatry services was lower post-ACA (IRR: 0.56, p < .01), and high-deductible plans were also related to lower use of psychiatry services (IRR: 0.30, p < .01). The relationship between marijuana use disorder and prescription opioid use is complex, and deserves further study, particularly with increasingly widespread marijuana legalization. Access to psychiatry services may be more challenging for buprenorphine patients post-ACA, especially for patients with deductible plans.

Authors+Show Affiliations

a Research Scientist, Division of Research , Kaiser Permanente Northern California Region , Oakland , CA , USA.b Economist, Division of Research , Kaiser Permanente Northern California Region , Oakland , CA , USA.a Research Scientist, Division of Research , Kaiser Permanente Northern California Region , Oakland , CA , USA.c Associate Professor, Department of Psychiatry , UCSF Weill Institute for Neurosciences, University of California, San Francisco , San Francisco , CA , USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28426332

Citation

Campbell, Cynthia I., et al. "Buprenorphine Treatment and Patient Use of Health Services After the Affordable Care Act in an Integrated Health Care System." Journal of Psychoactive Drugs, vol. 49, no. 2, 2017, pp. 160-168.
Campbell CI, Parthasarathy S, Young-Wolff KC, et al. Buprenorphine Treatment and Patient Use of Health Services after the Affordable Care Act in an Integrated Health Care System. J Psychoactive Drugs. 2017;49(2):160-168.
Campbell, C. I., Parthasarathy, S., Young-Wolff, K. C., & Satre, D. D. (2017). Buprenorphine Treatment and Patient Use of Health Services after the Affordable Care Act in an Integrated Health Care System. Journal of Psychoactive Drugs, 49(2), 160-168. https://doi.org/10.1080/02791072.2017.1305519
Campbell CI, et al. Buprenorphine Treatment and Patient Use of Health Services After the Affordable Care Act in an Integrated Health Care System. J Psychoactive Drugs. 2017 Apr-Jun;49(2):160-168. PubMed PMID: 28426332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Buprenorphine Treatment and Patient Use of Health Services after the Affordable Care Act in an Integrated Health Care System. AU - Campbell,Cynthia I, AU - Parthasarathy,Sujaya, AU - Young-Wolff,Kelly C, AU - Satre,Derek D, Y1 - 2017/04/20/ PY - 2017/4/21/pubmed PY - 2018/3/10/medline PY - 2017/4/21/entrez KW - Affordable Care Act KW - buprenorphine KW - health services utilization SP - 160 EP - 168 JF - Journal of psychoactive drugs JO - J Psychoactive Drugs VL - 49 IS - 2 N2 - The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258). Logistic and negative binomial regressions were used to model persistent buprenorphine use, and to examine whether persistent use was related to health services utilization. Buprenorphine patients were largely similar pre- and post-ACA, although more post-ACA patients had a marijuana use disorder (p < .01). Post-ACA patients were more likely to have high-deductible benefit plans (p < .01). Use of psychiatry services was lower post-ACA (IRR: 0.56, p < .01), and high-deductible plans were also related to lower use of psychiatry services (IRR: 0.30, p < .01). The relationship between marijuana use disorder and prescription opioid use is complex, and deserves further study, particularly with increasingly widespread marijuana legalization. Access to psychiatry services may be more challenging for buprenorphine patients post-ACA, especially for patients with deductible plans. SN - 2159-9777 UR - https://www.unboundmedicine.com/medline/citation/28426332/Buprenorphine_Treatment_and_Patient_Use_of_Health_Services_after_the_Affordable_Care_Act_in_an_Integrated_Health_Care_System_ L2 - https://www.tandfonline.com/doi/full/10.1080/02791072.2017.1305519 DB - PRIME DP - Unbound Medicine ER -