Abstract
Background: Follow-up after residential treatment is considered best practice in supporting patients with opioid use disorder (OUD) in their recovery. Yet, little is known about rates of follow-up after discharge. The objective of this analysis was to measure rates of follow-up and use of medications for OUD (MOUD) after residential treatment among Medicaid enrollees in 10 states, and to understand the enrollee and episode characteristics that are associated with both outcomes. Methods: Using a distributed research network to analyze Medicaid claims data, we estimated the likelihood of 4 outcomes occurring within 7 and 30 days post-discharge from residential treatment for OUD using multinomial logit regression: no follow-up or MOUD, follow-up visit only, MOUD only, or both follow-up and MOUD. We used meta-analysis techniques to pool state-specific estimates into global estimates. Results: We identified 90,639 episodes of residential treatment for OUD for 69,017 enrollees from 2018 to 2019. We found that 62.5% and 46.9% of episodes did not receive any follow-up or MOUD at 7 days and 30 days, respectively. In adjusted analyses, co-occurring mental health conditions, longer lengths of stay, prior receipt of MOUD or behavioral health counseling, and a recent ED visit for OUD were associated with a greater likelihood of receiving follow-up treatment including MOUD after discharge. Conclusions: Forty-seven percent of residential treatment episodes for Medicaid enrollees are not followed by an outpatient visit or MOUD, and thus are not following best practices.
Original language | English |
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Article number | 109670 |
Journal | Drug and Alcohol Dependence |
Volume | 241 |
DOIs | |
State | Published - Dec 1 2022 |
Bibliographical note
Funding Information:Evan Cole reports receiving salary support through an intergovernmental agreement with the Pennsylvania Department of Human Services. Andrew Barnes reports receiving research funding from the Commonwealth of Virginia to evaluate Medicaid programs. Peter Cunningham reports receiving research funding from the Commonwealth of Virginia to evaluate Medicaid programs. Julie Donohue reports receiving salary support through an intergovernmental agreement with the Pennsylvania Department of Human Services.
Funding Information:
This work was supported by Grant R01DA048029 from the National Institute on Drug Abuse. The funder did not have a role in the analysis.
Publisher Copyright:
© 2022 Elsevier B.V.
Keywords
- Follow-up
- Medicaid
- Opioid use disorder
- Residential treatment
ASJC Scopus subject areas
- Toxicology
- Pharmacology
- Psychiatry and Mental health
- Pharmacology (medical)