TY - JOUR
T1 - Outpatient follow-up and use of medications for opioid use disorder after residential treatment among Medicaid enrollees in 10 states
AU - Cole, Evan S.
AU - Allen, Lindsay
AU - Austin, Anna
AU - Barnes, Andrew
AU - Chang, Chung Chou H.
AU - Clark, Sarah
AU - Crane, Dushka
AU - Cunningham, Peter
AU - Fry, Carrie E.
AU - Gordon, Adam J.
AU - Hammerslag, Lindsey
AU - Idala, David
AU - Kennedy, Susan
AU - Kim, Joo Yeon
AU - Krishnan, Sunita
AU - Lanier, Paul
AU - Mahakalanda, Shyama
AU - Mauk, Rachel
AU - McDuffie, Mary Joan
AU - Mohamoud, Shamis
AU - Talbert, Jeff
AU - Tang, Lu
AU - Zivin, Kara
AU - Donohue, Julie M.
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - 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.
AB - 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.
KW - Follow-up
KW - Medicaid
KW - Opioid use disorder
KW - Residential treatment
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U2 - 10.1016/j.drugalcdep.2022.109670
DO - 10.1016/j.drugalcdep.2022.109670
M3 - Article
C2 - 36332591
AN - SCOPUS:85140981131
SN - 0376-8716
VL - 241
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 109670
ER -