TY - JOUR
KW - Cross-Sectional Studies
KW - Health Services Accessibility/economics
KW - Humans
KW - Regression Analysis
KW - Substance Abuse Treatment Centers/economics
KW - Substance-Related Disorders/economics/epidemiology/therapy
KW - United States
KW - United States Health Resources and Services Administration/economics
AU - N. Pourat
AU - B. O'Masta
AU - X. Chen
AU - C. Lu
AU - W. Zhou
AU - M. Daniel
AU - H. Hoang
AU - A. Sripipatana
A1 - 
AB - BACKGROUND: The opioid epidemic and subsequent mortality is a national concern in the U.S. The burden of this problem is disproportionately high among low-income and uninsured populations who are more likely to experience unmet need for substance use services. We assessed the impact of two Health Resources and Services Administration (HRSA) substance use disorder (SUD) service capacity grants on SUD staffing and service use in HRSA -funded health centers (HCs). METHODS AND FINDINGS: We conducted cross-sectional analyses of the Uniform Data System (UDS) from 2010 to 2017 to assess HC (n = 1,341) trends in capacity measured by supply of SUD and medication-assisted treatment (MAT) providers, utilization of SUD and MAT services, and panel size and visit ratio measured by the number of patients seen and visits delivered by SUD and MAT providers. We merged mortality and national survey data to incorporate SUD mortality and SUD treatment services availability, respectively. From 2010 to 2015, 20% of HC organizations had any SUD staff, had an average of one full-time equivalent SUD employee, and did not report an increase in SUD patients or SUD services. SUD capacity grew significantly in 2016 (43%) and 2017 (22%). MAT capacity growth was measured only in 2016 and 2017 and grew by 29% between those years. Receipt of both supplementary grants increased the probability of any SUD capacity by 35% (95% CI: 26%, 44%) and service use, but decreased the probability of SUD visit ratio by 680 visits (95% CI: -1,013, -347), compared to not receiving grants. CONCLUSIONS: The significant growth in HC specialized SUD capacity is likely due to supplemental SUD-specific HRSA grants and may vary by structure of grants. Expanding SUD capacity in HCs is an important step in increasing SUD access for low income and uninsured populations broadly and for patients of these organizations.
AD - Center for Health Policy Research, University of California, Los Angeles (UCLA), Los Angeles, CA, United States of America.; Fielding School of Public Health, UCLA, Los Angeles, CA, United States of America.; Center for Health Policy Research, University of California, Los Angeles (UCLA), Los Angeles, CA, United States of America.; Center for Health Policy Research, University of California, Los Angeles (UCLA), Los Angeles, CA, United States of America.; Center for Health Policy Research, University of California, Los Angeles (UCLA), Los Angeles, CA, United States of America.; Center for Health Policy Research, University of California, Los Angeles (UCLA), Los Angeles, CA, United States of America.; Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. All work related to this manuscript was completed as an employee of Bureau of Primary Health Care, Health Resources and Services Administration, Rockville, MD, United States of America.; Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD, United States of America.; Bureau of Primary Health Care, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, MD, United States of America.
BT - PloS one
C5 - Education & Workforce; Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
CP - 11
DO - 10.1371/journal.pone.0242407
IS - 11
JF - PloS one
LA - eng
M1 - Journal Article
N2 - BACKGROUND: The opioid epidemic and subsequent mortality is a national concern in the U.S. The burden of this problem is disproportionately high among low-income and uninsured populations who are more likely to experience unmet need for substance use services. We assessed the impact of two Health Resources and Services Administration (HRSA) substance use disorder (SUD) service capacity grants on SUD staffing and service use in HRSA -funded health centers (HCs). METHODS AND FINDINGS: We conducted cross-sectional analyses of the Uniform Data System (UDS) from 2010 to 2017 to assess HC (n = 1,341) trends in capacity measured by supply of SUD and medication-assisted treatment (MAT) providers, utilization of SUD and MAT services, and panel size and visit ratio measured by the number of patients seen and visits delivered by SUD and MAT providers. We merged mortality and national survey data to incorporate SUD mortality and SUD treatment services availability, respectively. From 2010 to 2015, 20% of HC organizations had any SUD staff, had an average of one full-time equivalent SUD employee, and did not report an increase in SUD patients or SUD services. SUD capacity grew significantly in 2016 (43%) and 2017 (22%). MAT capacity growth was measured only in 2016 and 2017 and grew by 29% between those years. Receipt of both supplementary grants increased the probability of any SUD capacity by 35% (95% CI: 26%, 44%) and service use, but decreased the probability of SUD visit ratio by 680 visits (95% CI: -1,013, -347), compared to not receiving grants. CONCLUSIONS: The significant growth in HC specialized SUD capacity is likely due to supplemental SUD-specific HRSA grants and may vary by structure of grants. Expanding SUD capacity in HCs is an important step in increasing SUD access for low income and uninsured populations broadly and for patients of these organizations.
PY - 2020
SN - 1932-6203; 1932-6203
T1 - Examining trends in substance use disorder capacity and service delivery by Health Resources and Services Administration-funded health centers: A time series regression analysis
T2 - PloS one
TI - Examining trends in substance use disorder capacity and service delivery by Health Resources and Services Administration-funded health centers: A time series regression analysis
U1 - Education & Workforce; Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
U2 - 33253263
U3 - 10.1371/journal.pone.0242407
VL - 15
VO - 1932-6203; 1932-6203
Y1 - 2020
Y2 - Nov 30
ER -