Literature Collection

81

Addressing Racial And Ethnic Disparities In The Use Of Medications For Opioid Use Disorder

Type: Journal Article

Authors: Barbara Andraka-Christou

Year: 2021

Publication Place: Bethesda, Maryland

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82

Addressing the Social Determinants of Health Through Medicaid Managed Care

Type: Report

Authors: David Machledt

Year: 2017

Topic(s):

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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83

Adherence to practice guidelines, clinical outcomes, and costs among Medicaid enrollees with severe mental illnesses

Type: Journal Article

Authors: Paul G. Stiles, Roger A. Boothroyd, Kelley Dhont, Pamela F. Beiler, Amy E. Green

Year: 2009

Publication Place: US: Sage Publications

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84

Adherence trajectories of buprenorphine therapy among pregnant women in a large state Medicaid program in the United States

Type: Journal Article

Authors: Wei-Hsuan Lo-Ciganic, Julie M. Donohue, Joo Yeon Kim, Elizabeth E. Krans, Bobby L. Jones, David Kelley, Alton E. James, Marian P. Jarlenski

Year: 2018

Publication Place: England

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85

Administration of naloxone in a home or community setting: A review of the clinical effectiveness, cost-effectiveness, and guidelines. (CADTH rapid response report: summary with critical appraisal)

Type: Government Report

Authors: Yi-Sheng Chao, Hannah Loshak

Year: 2019

Publication Place: Ottawa

Abstract:

Opioid overdose can induce acute respiratory and central nervous system depression that may lead to death. Recently the numbers of opioid-related deaths or hospitalizations have increased in Canada and there is an ongoing opioid crisis. Naloxone, a medication that temporarily blocks the effects of opioids, has been advocated for a wider use in the communities. Naloxone works by competing for opioid receptors with opioids and remains active in the body for 20 to 90 minutes, shorter than most opioids. Without opioids, naloxone has little pharmacologic activity. Data from noncomparative studies suggest that naloxone use in a home or community setting for opioid overdose is associated with a low mortality rate. In Canada, take-home naloxone kits are available at most pharmacies without a prescription and are free in some provinces. This report aims to update a previous CADTH review on the clinical effectiveness and cost effectiveness of the administration of naloxone in a home or community setting, as well as to identify evidence-based guidelines for its use.

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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86

Adolescent emotional/behavioral problems and risk behavior in Ontario primary care: Comorbidities and costs

Type: Journal Article

Authors: Carolyn Byrne, Gina Browne, Jacqueline Roberts, Amiram Gafhi, Barbara Bell, Lori Chalklin, Jim Kraemer, Michael Mills, David Wallik

Year: 2004

Publication Place: US: Springer Publishing

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87

Adolescent-Serving Addiction Treatment Facilities in the United States and the Availability of Medications for Opioid Use Disorder

Type: Journal Article

Authors: R. H. Alinsky, S. E. Hadland, P. A. Matson, M. Cerda, B. Saloner

Year: 2020

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88

Adoption of Electronic Health Record Among Substance Use Disorder Treatment Programs: Nationwide Cross-Sectional Survey Study

Type: Journal Article

Authors: J. A. Frimpong, X. Liu, L. Liu, R. Zhang

Year: 2023

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89

Adoption of injectable naltrexone in U.S. substance use disorder treatment programs

Type: Journal Article

Authors: L. Aletraris, Bond Edmond, P. M. Roman

Year: 2015

Publication Place: United States

Abstract: OBJECTIVE: Medication-assisted treatment for substance use disorders (SUDs) is not widely used in treatment programs. The aims of the current study were to document the prevalence of adoption and implementation of extended-release injectable naltrexone, the newest U.S. Food and Drug Administration-approved medication for alcohol use disorder (AUD), in U.S. treatment programs and to examine associations between organizational and patient characteristics and adoption. METHOD: The study used interview data from a nationally representative sample of 307 U.S. SUD treatment programs to examine adoption and implementation of injectable naltrexone. RESULTS: Thirteen percent of programs used injectable naltrexone for AUD, and 3% of programs used it for opioid use disorder. Every treatment program that offered injectable naltrexone to its patients used it in conjunction with psychosocial treatment, particularly cognitive behavioral therapy. Multivariate logistic regression results indicated that adoption was positively associated with the provision of wraparound services, the percentage of privately insured patients, and the presence of inpatient detoxification services. For-profit status and offering inpatient services were negatively associated with adoption. Within adopting programs, an average of 4.1% of AUD patients and 7.1% of patients with opioid use disorder were currently receiving the medication, despite clinical directors' reports of positive patient outcomes, particularly for relapsers and for those who had been noncompliant with other medications. Cost was a significant issue for the majority of adopting organizations. CONCLUSIONS: The rate of adoption of injectable naltrexone in U.S. treatment programs remains limited. Researchers should continue to examine patient, organizational, and external characteristics associated with the adoption and implementation of injectable naltrexone over time.

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90

Adult health care services and psychiatric disorders: The use and costs of health care services in a low income, minority population coming to an urban primary care clinic

Type: Web Resource

Authors: Sarah Elizabeth Bledsoe

Year: 2007

Publication Place: US

Abstract: Background. Psychiatric disorders are associated with increased rates of medical problems and reduced life expectancies. Undiagnosed psychiatric disorders are associated with "overuse" or "misuse" of general medical health care services placing a burden on the general medical health care services delivery system. This problem is particularly relevant in low income, minority patients because the burden of psychiatric disorders is disproportionate. This group of patients has higher prevalence of psychiatric disorders. Furthermore, low-income, minority patients are less likely to seek mental health services, less likely to receive quality, specialty mental health services, and rely heavily on general medical health care services providers for mental health treatment. This study aims to determine the role of psychiatric disorders in the cost and utilization of general medical health care services (excluding mental health care services) for a low-income, minority patient population coming to a primary health care clinic. This research is guided by prior research in two distinct areas: the cost-offset effect and the behavioral health care model. Method. Secondary data analysis of a cross-sectional survey was used to test the relationship between psychiatric disorders and the types, rates, level of utilization, and cost of general medical health care services in a sample consisting of 1,063 primary care patients at an urban primary care clinic that serves a predominantly immigrant and low-income community. Separate multiple linear regression analyses were conducted both with and without the dichotomous variable indicating presence of a current psychiatric disorder to examine whether there was a significant positive relationship between the presence of a current psychiatric disorder and the level of general medical health care services utilization and the cost of general medical health care services. Separate analyses were run to determine the effects of hypothesized moderating variables: enabling resources and past use of mental health services. Multiple logistic regression analysis was used to examine the hypothesized differences between low and high utilizers of general medical health care services. Results. In a sample of primarily low-income, minority, and immigrant primary care patients participants with current psychiatric disorders had greater levels of utilization (M = 11.85, SD = 8.15) and cost (M= $4,901.94, SD = 11, 226.29) related to general medical health care services when compared to the sample of participants without current psychiatric disorders (utilization M = 10.86, SD = 8.15; cost M = $3,606.03, SD = 5,673.47) after controlling for predisposing characteristics, need, and enabling factors. Having comorbid psychiatric disorders was not significantly associated with either the level of utilization or the cost of general medical health care services. Furthermore, the category of psychiatric disorder (mood, anxiety, or substance related) was not associated with utilization or cost of general medical health care services. The hypothesized moderating relationship of enabling resources and past use of mental health services on the association between having a current psychiatric disorder and both cost and utilization of general medical health care services was not supported. Significant differences were detected in the psychiatric sample between the subset of participants who utilized low levels of general medical health care services and the subset of those who utilized high levels of general medical health care services. The low level utilizers were more likely to be Spanish speaking, have alcohol use disorder, and be exposed to more categories of traumatic events. Participants with psychiatric disorders who had Medicaid and those who were disabled were more likely to be high level utilizers of general medical health care service. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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91

Adult Primary Care Physician Visits Increasingly Address Mental Health Concerns

Type: Journal Article

Authors: L. S. Rotenstein, S. T. Edwards, B. E. Landon

Year: 2023

Abstract:

A high prevalence of mental health diagnoses in adults alongside ongoing shortages of mental health specialists and expansion of the patient-centered medical home have increased the involvement of primary care clinicians in treating mental health concerns. Using nationally representative serial cross-sectional data from the 2006-18 National Ambulatory Medical Care Surveys regarding visits to outpatient primary care physicians by patients ages eighteen and older, we sought to characterize temporal trends in primary care visits addressing a mental health concern. Based on a sample of 109,898 visits representing 3,891,233,060 weighted visits, we found that the proportion of visits that addressed mental health concerns increased from 10.7 percent of visits in 2006-07 to 15.9 percent by 2016 and 2018. Black patients were 40 percent less likely than White patients to have a mental health concern addressed during a primary care visit, and Hispanic patients were 40 percent less likely than non-Hispanic patients to have a mental health concern addressed during a primary care visit. These findings emphasize the need for payment and billing approaches (that is, value-based care models and billing codes for integrated behavioral health) as well as organizational designs and supports (that is, colocated therapy or psychiatry providers, availability of e-consultation, and longer visits) that enable primary care physicians to adequately address mental health needs.

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92

Advancing Primary Care Innovation in Medicaid Managed Care: A Toolkit for States

Type: Report

Authors: Diana Crumley, Rachael Matulis, Kelsey Brykman, Brittany Lee, Michelle Conway

Year: 2019

Topic(s):

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Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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93

Advancing the evidence for integrated pediatric primary care psychology: A call to action

Type: Journal Article

Authors: Meghan McAuliffe Lines

Year: 2019

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94

Aligning incentives in the treatment of depression in primary care with evidence-based practice

Type: Journal Article

Authors: Richard G. Frank, Haiden A. Huskamp, Harold Alan Pincus

Year: 2003

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95

Aligning Payers and Practices to Transform Primary Care: A Report from the Multi-State Collaborative

Type: Report

Authors: LD Watkins

Year: 2014

Publication Place: New York, NY

Abstract: Since the mid-2000s, a number of states have developed and implemented initiatives to transform their primary care delivery systems in order to improve the health of their populations and reduce costs. These initiatives bring together health care providers and payers in collaborative efforts to implement patient-centered medical homes and promote payment reform by aligning incentives across all payers. What the states have learned from their experiences is that primary care transformation can only be achieved through change to both systems-organizing and paying for care.

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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96

Alternative Payment Models (APM) Framework

Type: Report

Authors: Health Care Payment Learning & Action Network

Year: 2016

Topic(s):

,

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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97

Alternative Payment Models for Sustaining Integration - Dr. Roger Kathol [Video]

Type: Web Resource

Authors: University of Colorado School of Medicine Department of Family Medicine

Year: 2013

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98

An agent-based simulation model of patient choice of health care providers in accountable care organizations

Type: Journal Article

Authors: A. Alibrahim, S. Wu

Year: 2018

Publication Place: Netherlands

Abstract: Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers. This simulation focuses on Medicare beneficiaries and their congestive heart failure (CHF) outcomes. We place the patient agents in an ACO delivery system model in which provider agents decide if they remain in an ACO and perform a quality improving CHF disease management intervention. Illustrative results show that allowing patients to choose their providers reduces the yearly payment per CHF patient by $320, reduces mortality rates by 0.12 percentage points and hospitalization rates by 0.44 percentage points, and marginally increases provider participation in ACO. This study demonstrates a model capable of quantifying the effects of patient choice in a theoretical ACO system and provides a potential tool for policymakers to understand implications of patient choice and assess potential policy controls.

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99

An agent-based simulation model of patient choice of health care providers in accountable care organizations

Type: Journal Article

Authors: A. Alibrahim, S. Wu

Year: 2018

Publication Place: Netherlands

Abstract: Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers. This simulation focuses on Medicare beneficiaries and their congestive heart failure (CHF) outcomes. We place the patient agents in an ACO delivery system model in which provider agents decide if they remain in an ACO and perform a quality improving CHF disease management intervention. Illustrative results show that allowing patients to choose their providers reduces the yearly payment per CHF patient by $320, reduces mortality rates by 0.12 percentage points and hospitalization rates by 0.44 percentage points, and marginally increases provider participation in ACO. This study demonstrates a model capable of quantifying the effects of patient choice in a theoretical ACO system and provides a potential tool for policymakers to understand implications of patient choice and assess potential policy controls.

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100

An economic evaluation of community pharmacy-dispensed naloxone in Canada

Type: Journal Article

Authors: A. Cid, N. Mahajan, W. W. L. Wong, M. Beazely, K. A. Grindrod

Year: 2024

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