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Opioids & SU

The Literature Collection contains over 11,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More

Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).

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11202 Results
721
Access to OUD Treatment and Maintenance of Sobriety amid the COVID-19 Pandemic
Type: Journal Article
Authors: Fatima Rahman, NaKiera Evans, Jean Bernhardt
Year: 2021
Publication Place: Philadelphia
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
722
Access to Prenatal Care Among Patients With Opioid Use Disorder in Florida: Findings From a Secret Shopper Study
Type: Journal Article
Authors: K. Fryer, C. N. Reid, A. L. Elmore, S. Mehra, C. Carr, J. L. Salemi, C. R. Cogle, C. Pelletier, Pacheco Garrillo, W. S. Sappenfield, J. Marshall
Year: 2023
Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
,
Education & Workforce See topic collection
,
Financing & Sustainability See topic collection
723
Access to primary care services for homeless mentally ill people
Type: Journal Article
Authors: M. Woollcott
Year: 2008
Publication Place: England
Abstract: Modernisation of mental health services has been a government priority in recent years with new legislation, increased funding and investment and service reforms. The National Service Framework (NSF) for Mental Health defines national standards to meet the mental healthcare needs of adults up to the age of 65. This article considers standards two and three of the NSF regarding access to primary care services for people with a mental health problem. It discusses whether these standards consider homeless people, who continue to experience significant problems gaining equal access to health care.
Topic(s):
Healthcare Disparities See topic collection
,
Healthcare Policy See topic collection
724
Access to primary mental health care for hard-to-reach groups: From 'silent suffering' to 'making it work'
Type: Journal Article
Authors: Marija Kovandzic, Carolyn Chew-Graham, Joanne Reeve, Suzanne Edwards, Sarah Peters, Dawn Edge, Saadia Aseem, Linda Gask, Christopher Dowrick
Year: 2011
Publication Place: URL
Topic(s):
General Literature See topic collection
725
Access to Services for Pregnant People With Opioid Use Disorder in Jails in the United States
Type: Journal Article
Authors: C. E. Grella, C. K. Scott, M. L. Dennis, R. A. LaVallee
Year: 2023
Abstract:

The aim of this study was to assess the availability of medications for opioid use disorder (MOUD) and other services for pregnant people in jails in counties heavily impacted by opioid overdose in the United States. Counties were selected based on absolute number and population rate of opioid-overdose fatalities. Structured interviews were completed with representatives from 174 jails that house pregnant women. Descriptive statistics examine MOUD availability and differences in service provision and community-level characteristics based on MOUD availability. Most jails in the study sample (84.5%) had MOUD available for pregnant people; however, less than half of these jails ensured continuity of care. Jails without MOUD available are more likely to provide non-MOUD substance use services. These jails are more often located in smaller, rural counties in the Midwest and have higher rates of White residents and lower rates of Hispanic and African American residents. Gaps in MOUD availability in jails and continuity of care violate medical guidelines for treatment of pregnant patients with opioid use disorder and increase their risk of overdose. In addition, there are disparities across communities in access to MOUD for pregnant people in jails.

Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
,
Education & Workforce See topic collection
726
Access to timely mental health care treatment initiation among Veterans Health Administration patients with and without serious mental illness
Type: Journal Article
Authors: Sharon M. Nelson, Jennifer J. Mach, Tyler C. Hein, Kristen M. Abraham, Jenefer M. Jedele, Nicholas W. Bowersox
Year: 2022
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
727
Access to treatment for adolescents with substance use and co-occurring disorders: Challenges and opportunities
Type: Journal Article
Authors: S. Sterling, C. Weisner, A. Hinman, S. Parthasarathy
Year: 2010
Publication Place: United States
Abstract: OBJECTIVE: To review the research on economic and systemic barriers faced by adolescents needing treatment for alcohol and drug problems, particularly those with co-occurring conditions. METHOD: We reviewed the literature on adolescent access to alcohol and drug services, including early intervention, and integrated and specialty mental health treatment for those with co-occurring disorders, examining the role of health care systems, public policy (health reform), treatment financing and reimbursement systems (public and private), implementation of evidence-based practices, confidentiality practices, and treatment costs and cost/benefits. RESULTS: Barriers to treatment, particularly integrated treatment, are largely rooted in our organizationally fragmented health care system, which encompasses public and private, carved-out and integrated systems, and different funding mechanisms (Medicaid versus block grants versus private insurance that include "high deductible" plans and other cost controls.) In both systems, carved-out programs de-link services from other mental health and general health care. Barriers are also rooted in disciplinary differences and weak clinical linkages between psychiatry, primary care and substance use, and in confidentiality policies that inhibit communication and coordination, while protecting patient privacy. CONCLUSION: In this era of health care reform, we have the opportunity to increase access for adolescents and develop new models of integrated services for those with co-occurring conditions. We discuss opportunities for improving treatment access and implementation of evidence-based practices, examine implications of health reform and parity legislation for psychiatric and substance use treatment, and comment on key unanswered questions and future research opportunities.
Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Policy See topic collection
729
Access to treatment for opioid use disorders: Medical student preparation
Type: Journal Article
Authors: E. F. McCance-Katz, P. George, N. A. Scott, R. Dollase, A. R. Tunkel, J. McDonald
Year: 2017
Publication Place: England
Topic(s):
Opioids & Substance Use See topic collection
731
Access, Utilization, and Quality of Behavioral Health Integration in Medicaid Managed Care
Type: Journal Article
Authors: K. J. McConnell, S. Edelstein, J. Hall, A. Levy, M. Danna, D. J. Cohen, J. Unutzer, J. M. Zhu, S. Lindner
Year: 2023
Abstract:

IMPORTANCE: Many states have moved from models that carve out to those that carve in or integrate behavioral health in their Medicaid managed care organizations (MCOs), but little evidence exists about the effect of this change. OBJECTIVE: To assess the association of the transition to integrated managed care (IMC) in Washington Medicaid with health services use, quality, health-related outcomes, and measures associated with social determinants of health. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used difference-in-differences analyses of Washington State's 2014 to 2019 staggered rollout of IMC on claims-based measures for enrollees in Washington's Medicaid MCO. It was supplemented with interviews of 24 behavioral health agency leaders, managed care administrators, and individuals who were participating in the IMC transition. The data were analyzed between February 1, 2023, and September 30, 2023. MAIN OUTCOMES AND MEASURES: Claims-based measures of utilization (including specialty mental health visits and primary care visits); health-related outcomes (including self-harm events); rates of arrests, employment, and homelessness; and additional quality measures. RESULTS: This cohort study included 1 454 185 individuals ages 13 to 64 years (743 668 female [51.1%]; 14 306 American Indian and Alaska Native [1.0%], 132 804 Asian American and Pacific Islander [9.1%], 112 442 Black [7.7%], 258 389 Hispanic [17.8%], and 810 304 White [55.7%] individuals). Financial integration was not associated with changes in claims-based measures of utilization and quality. Most claims-based measures of outcomes were also unchanged, although enrollees with mild or moderate mental illness experienced a slight decrease in cardiac events (-0.8%; 95% CI, -1.4 to -0.2), while enrollees with serious mental illness experienced small decreases in employment (-1.2%; 95% CI -1.9 to -0.5) and small increases in arrests (0.5%; 95% CI, 0.1 to 1.0). Interviews with key informants suggested that financial integration was perceived as an administrative change and did not have substantial implications for how practices delivered care; behavioral health agencies lacked guidance on how to integrate care in behavioral health settings and struggled with new contracts and regulatory policies that may have inhibited the ability to provide integrated care. CONCLUSIONS AND RELEVANCE: The results of this cohort study suggest that financial integration at the MCO level was not associated with significant changes in most measures of utilization, quality, outcomes, and social determinants of health. Additional support, including monitoring, training, and funding, may be necessary to drive delivery system changes to improve access, quality, and outcomes.

Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
732
Accessibility of substance use treatment: A qualitative study from the non-service users' perspective
Type: Journal Article
Authors: Laura Caris, Thijs Beckers
Year: 2022
Topic(s):
Opioids & Substance Use See topic collection
733
Accessibility to Medication for Opioid Use Disorder After Interventions to Improve Prescribing Among Nonaddiction Clinics in the US Veterans Health Care System
Type: Journal Article
Authors: E. J. Hawkins, C. A. Malte, A. J. Gordon, E. C. Williams, H. J. Hagedorn, K. Drexler, B. E. Blanchard, J. L. Burden, J. Knoeppel, A. N. Danner, A. Lott, J. G. Liberto, A. J. Saxon
Year: 2021
Abstract:

IMPORTANCE: With increasing rates of opioid use disorder (OUD) and overdose deaths in the US, increased access to medications for OUD (MOUD) is paramount. Rigorous effectiveness evaluations of large-scale implementation initiatives using quasi-experimental designs are needed to inform expansion efforts. OBJECTIVE: To evaluate a US Department of Veterans Affairs (VA) initiative to increase MOUD use in nonaddiction clinics. DESIGN, SETTING, AND PARTICIPANTS: This quality improvement initiative used interrupted time series design to compare trends in MOUD receipt. Primary care, pain, and mental health clinics in the VA health care system (n = 35) located at 18 intervention facilities and nonintervention comparison clinics (n = 35) were matched on preimplementation MOUD prescribing trends, clinic size, and facility complexity. The cohort of patients with OUD who received care in intervention or comparison clinics in the year after September 1, 2018, were evaluated. The preimplementation period extended from September 1, 2017, through August 31, 2018, and the postimplementation period from September 1, 2018, through August 31, 2019. EXPOSURES: The multifaceted implementation intervention included education, external facilitation, and quarterly reports. MAIN OUTCOMES AND MEASURES: The main outcomes were the proportion of patients receiving MOUD and the number of patients per clinician prescribing MOUD. Segmented logistic regression evaluated monthly proportions of MOUD receipt 1 year before and after initiative launch, adjusting for demographic and clinical covariates. Poisson regression models examined yearly changes in clinician prescribing over the same time frame. RESULTS: Overall, 7488 patients were seen in intervention clinics (mean [SD] age, 53.3 [14.2] years; 6858 [91.6%] male; 1476 [19.7%] Black, 417 [5.6%] Hispanic; 5162 [68.9%] White; 239 [3.2%] other race [including American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and multiple races]; and 194 [2.6%] unknown) and 7558 in comparison clinics (mean [SD] age, 53.4 [14.0] years; 6943 [91.9%] male; 1463 [19.4%] Black; 405 [5.4%] Hispanic; 5196 [68.9%] White; 244 [3.2%] other race; 250 [3.3%] unknown). During the preimplementation year, the proportion of patients receiving MOUD in intervention clinics increased monthly by 5.0% (adjusted odds ratio [AOR], 1.05; 95% CI, 1.03-1.07). Accounting for this preimplementation trend, the proportion of patients receiving MOUD increased monthly by an additional 2.3% (AOR, 1.02; 95% CI, 1.00-1.04) during the implementation year. Comparison clinics increased by 2.6% monthly before implementation (AOR, 1.03; 95% CI, 1.01-1.04), with no changes detected after implementation. Although preimplementation-year trends in monthly MOUD receipt were similar in intervention and comparison clinics, greater increases were seen in intervention clinics after implementation (AOR, 1.04; 95% CI, 1.01-1.08). Patients treated with MOUD per clinician in intervention clinics saw greater increases from before to after implementation compared with comparison clinics (incidence rate ratio, 1.50; 95% CI, 1.28-1.77). CONCLUSIONS AND RELEVANCE: A multifaceted implementation initiative in nonaddiction clinics was associated with increased MOUD prescribing. Findings suggest that engagement of clinicians in general clinical settings may increase MOUD access.

Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
734
Accessibility Versus Quality of Care Plus Retention: The Formula for Service Delivery in Australian Opioid Replacement Therapy?
Type: Journal Article
Authors: Warren Harlow, Marian W. Roman, Brenda Happell, Graeme Browne
Year: 2013
Topic(s):
Opioids & Substance Use See topic collection
735
Accessing perinatal substance use disorder care in your local community: A case study of an innovative hub and spoke network in western North Carolina
Type: Journal Article
Authors: R. Bass, G. Flinchum, M. Ramage, S. L. Galvin, Cabello- De la Garza, O. Caron, A. Marietta
Year: 2024
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
736
Accessing perinatal substance use disorder care in your local community: A case study of an innovative hub and spoke network in western North Carolina
Type: Journal Article
Authors: R. Bass, G. Flinchum, M. Ramage, S. L. Galvin, Cabello- De la Garza, O. Caron, A. Marietta
Year: 2024
Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
737
Accountable Care Organization Formation Is Associated With Integrated Systems But Not High Medical Spending
Type: Journal Article
Authors: D. I. Auerbach, H. Liu, P. S. Hussey, C. Lau, A. Mehrotra
Year: 2013
Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Policy See topic collection
738
Accountable care organizations: Value metrics and capital formation
Type: Book
Authors: Robert James Cimasi
Year: 2013
Publication Place: Portland, Oregon
Topic(s):
Grey Literature See topic collection
,
Financing & Sustainability See topic collection
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.

739
Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
Type: Journal Article
Authors: N. Z. Counts, G. Wrenn, D. Muhlestein
Year: 2019
Publication Place: United States
Abstract: Value-based payment initiatives, such as the Medicare Shared Savings Program (MSSP), offer the possibility of using financial incentives to drive improvements in mental health and substance use outcomes. In the past 2 years, Accountable Care Organizations (ACOs) participating in the MSSP began to publicly report on one behavioral health outcome-Depression Remission at Twelve Months, which may indicate how value-based payment incentives have impacted mental health and substance use, and if reforms are needed. For ACOs that meaningfully reported performance on the depression remission measure in 2017, the median rate of depression remission at 12 months was 8.33%. A recent meta-analysis found that the average rate of spontaneous depression remission at 12 months absent treatment was approximately 53%. Although a number of factors likely explain these results, the current ACO design does not appear to incentivize improved behavioral health outcomes. Four changes in value-based payment incentive design may help to drive better outcomes: (1) making data collection easier, (2) increasing the salience of incentives, (3) building capacity to implement new interventions, and (4) creating safeguards for inappropriate treatment or reporting.
Topic(s):
Financing & Sustainability See topic collection
,
Opioids & Substance Use See topic collection
740
Accountable Care Organizations' Performance in Depression: Lessons for Value-Based Payment and Behavioral Health
Type: Journal Article
Authors: N. Z. Counts, G. Wrenn, D. Muhlestein
Year: 2019
Publication Place: United States
Abstract: Value-based payment initiatives, such as the Medicare Shared Savings Program (MSSP), offer the possibility of using financial incentives to drive improvements in mental health and substance use outcomes. In the past 2 years, Accountable Care Organizations (ACOs) participating in the MSSP began to publicly report on one behavioral health outcome-Depression Remission at Twelve Months, which may indicate how value-based payment incentives have impacted mental health and substance use, and if reforms are needed. For ACOs that meaningfully reported performance on the depression remission measure in 2017, the median rate of depression remission at 12 months was 8.33%. A recent meta-analysis found that the average rate of spontaneous depression remission at 12 months absent treatment was approximately 53%. Although a number of factors likely explain these results, the current ACO design does not appear to incentivize improved behavioral health outcomes. Four changes in value-based payment incentive design may help to drive better outcomes: (1) making data collection easier, (2) increasing the salience of incentives, (3) building capacity to implement new interventions, and (4) creating safeguards for inappropriate treatment or reporting.
Topic(s):
Financing & Sustainability See topic collection
,
Opioids & Substance Use See topic collection