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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).
12581 Results
10921
The economic burden of neonatal abstinence syndrome in the United States
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links: 
View the DOI record for The economic burden of neonatal abstinence syndrome in the United States
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View the PubMed citation for The economic burden of neonatal abstinence syndrome in the United States10922
The Economic Burden of Opioid Abuse: Updated Findings
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: BACKGROUND: Opioid pain relievers can be highly effective in providing relief for patients suffering from pain. At the same time, prescription opioid abuse, dependence, overdose, and poisoning (hereinafter "abuse") have become a national public health concern. Opioid abuse is also costly: previous estimates of the annual excess costs of opioid abuse to payers range from approximately $10,000 to $20,000 per patient. OBJECTIVES: To (a) provide a comprehensive, current estimate of the economic burden of opioid abuse to commercial payers and (b) explore the drivers of these excess costs of abuse. METHODS: Administrative claims from beneficiaries covered by large self-insured companies throughout the United States were used to identify patients diagnosed with opioid abuse, dependence, and overdose/poisoning ("abuse") between 2012 and 2015. Sample selection criteria identified patients most likely to be misusing opioids. Abusers and nonabuser controls were matched using propensity scores. Excess health care costs were assessed over the 18-month study period. Drivers of excess costs were then evaluated by place of service and medical condition (identified as 3-digit ICD-9-CM groupings). RESULTS: 9,342 matched abuser/nonabuser pairs were analyzed. Relative to nonabusers, abusers had significantly higher annual health care resource utilization, leading to $14,810 in per-patient incremental annual health care costs. Excess costs began accumulating 5 months before the formal, incident diagnosis of abuse, driven by alcohol and nonopioid substance abuse. Major drivers of excess costs of abuse included opioid and other substance abuse disorders, mental health conditions, and painful conditions. Many patients had diagnoses for other substance abuse that predated their opioid abuse diagnoses. CONCLUSIONS: Opioid abuse imposes a substantial economic burden on payers and often occurs in the context of other substance abuse. Poly-substance abuse often precedes the diagnosis of opioid abuse. DISCLOSURES: This study was funded by Purdue Pharma. Mayne is an employee of Purdue Pharma. Kirson, Scarpati, and Birnbaum are employees of Analysis Group, which received funding from Purdue Pharma to conduct this study. Enloe and Dincer were employees of Analysis Group at the time this research was conducted. Study concept and design were contributed by Kirson, Birnbaum, Mayne, and Scarpati, along with Enloe and Dincer. Enloe and Dincer took the lead in data collection, along with Birnbaum and assisted by Kirson and Scarpati. Data interpretation was performed by all the authors. The manuscript was written and revised by Kirson and Scarpati, along with Mayne and Birnbaum.
Topic(s):
Opioids & Substance Use
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, Financing & Sustainability
See topic collection
10923
The economic cost of chronic fatigue and chronic fatigue syndrome in UK primary care
Type: Journal Article
Year: 2003
Publication Place: England
Abstract: BACKGROUND: Chronic fatigue and chronic fatigue syndrome are most often encountered in primary care settings. Given the disabling nature of chronic fatigue it may have a substantial impact on service use and costs as well as on employment. This study estimates this impact. METHOD: Patients presenting to general practitioners with unexplained chronic fatigue were recruited to the study. Service use over a 3 month period was measured and lost employment recorded. These data were used to estimate economic costs. Patients with chronic fatigue syndrome were compared to patients with only chronic fatigue using a multiple regression model with sample differences controlled. RESULTS: The mean total cost of services and lost employment across the sample was Pound Sterling1906 for the 3-month period with formal services accounting for 9.3% of this figure. Service use was higher for patients with chronic fatigue syndrome compared to those with chronic fatigue alone. Total 3-month costs were on average higher for chronic fatigue syndrome (Pound Sterling3515 v. Pound Sterling1176) but when sample differences were taken account of the mean difference was reduced to Pound Sterling1406 (P = 0.086). Over 90% of the cost was accounted for by care provided by friends and family members and by lost employment. Patients with dependants had significantly higher costs than those with none and costs were also significantly higher for greater levels of functional impairment. CONCLUSION: Chronic fatigue imposes substantial economic costs on society, mainly in the form of informal care and lost employment. Treatments need to be developed which recognize these impacts.
Topic(s):
Financing & Sustainability
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Reference Links: View the PubMed citation for The economic cost of chronic fatigue and chronic fatigue syndrome in UK primary care
10925
The economics of depression in primary care: de-fragmentation in the Oregon Medicaid market
Type: Journal Article
Year: 2006
Topic(s):
Healthcare Policy
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Reference Links:
View the DOI record for The economics of depression in primary care: de-fragmentation in the Oregon Medicaid market
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View the PubMed citation for The economics of depression in primary care: de-fragmentation in the Oregon Medicaid market10926
The economics of integrated depression care: the University of Michigan study
Type: Journal Article
Year: 2006
Topic(s):
General Literature
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Reference Links:
View the DOI record for The economics of integrated depression care: the University of Michigan study
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View the PubMed citation for The economics of integrated depression care: the University of Michigan study10928
The Effect of a Payer-Mandated Decrease in Buprenorphine Dose on Aberrant Drug Tests and Treatment Retention Among Patients with Opioid Dependence
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Opioids & Substance Use
See topic collection
10930
The effect of behavioral health consultation on the care of depression by primary care clinicians
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: PURPOSE: The aim of this study is to assess the impact of an integrated care model, called the Behavioral Health Consultation model, in the delivery of care for depression in an urban Federally Qualified Health Center, and to gauge the receptiveness of primary care clinicians to increasing their responsibility for the mental health care of their patients. METHODS: We reviewed electronic medical records to measure referral rates to mental health specialty care, patient engagement in care, management of psychotropic medications, and initiation of antidepressant medication, comparing data from the year prior to program implementation to that from the third year post-implementation. Clinician attitudes were assessed using an online anonymous questionnaire. RESULTS: Statistically significant findings included post-implementation increases in the use of standardized measures of depression, documentation of behavioral goals and patient visits to the primary care clinician (increased engagement), decreases in initiation rates of antidepressant medications, and decreases in referrals to mental health specialty care. No significant difference was found in rates of dosage changes or change to new medications among patients who were already on psychiatric medications. Clinicians reported near universal acceptance of the behavioral health consultation program and willingness to increase their role in managing patient mental health issues. CONCLUSIONS: This study demonstrates that a behavioral health consultation program in an urban community health center can improve adherence to evidence-based indicators in the care of depression, making it possible to manage the majority of patients presenting with depression in the primary care setting.
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for The effect of behavioral health consultation on the care of depression by primary care clinicians
10931
The effect of context in rural mental health care: Understanding integrated services in a small town
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
Healthcare Disparities
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Reference Links: View the PubMed citation for The effect of context in rural mental health care: Understanding integrated services in a small town
10932
The effect of improving primary care depression management on employee absenteeism and productivity. A randomized trial
Type: Journal Article
Year: 2004
Topic(s):
Education & Workforce
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10933
The Effect of Integrating Primary Care and Mental Health Services on Diabetes and Depression: A Multi-site Impact Evaluation on the US-Mexico Border
Type: Journal Article
Year: 2021
Publication Place: United States
Abstract:
BACKGROUND: Health care delivery systems are increasingly integrating physical and mental health services to address patients' complex needs, contain costs, and improve satisfaction. Therefore, it is critical to understand whether adoption of integrated care models is effective in diverse settings. OBJECTIVE: This study examined the effect of integrated care on physical and mental health outcomes among low-income Latino participants on the US-Mexico border. RESEARCH DESIGN: In this quasi-experimental multisite study, individual-level data were pooled from 8 studies of locally adapted integrated care models. SUBJECTS: Participants were 18 years or older and had 1 or more chronic conditions: diabetes, depression, hypertension, or obesity. The study enrolled 4226 participants with 2254 participants in the intervention group and 1972 in the comparison group. MEASURES: Primary outcomes were depressive symptoms as measured by the Patient Health Questionnaire-9 score and blood glucose measured by hemoglobin A1c (HbA1c). Blood pressure, body mass index, and quality of life were secondary outcomes. RESULTS: Multivariable linear regression analyses indicated intervention participants had significantly lower Patient Health Questionnaire-9 scores (β=-0.39, P=0.03) and HbA1c (β=-0.14, P=0.02) at 12 months compared with comparison group participants. Stratified analyses showed improvements in HbA1c were even greater among intervention participants who had diabetes, depression, severe and persistent mental illness, were older or female compared with their counterparts in the comparison group. CONCLUSIONS: Health care is constantly transforming, making it critical to study these changes across populations and settings. Findings from this study indicate that integrated care can significantly improve mental and physical health in an underserved Latino population.
Topic(s):
Healthcare Disparities
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, Measures
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10934
The effect of Medicaid expansion on use of opioid agonist treatment and the role of provider capacity constraints
Type: Journal Article
Year: 2020
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Disparities
See topic collection
, Healthcare Policy
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for The effect of Medicaid expansion on use of opioid agonist treatment and the role of provider capacity constraints
View DOI Record
View the PubMed citation for The effect of Medicaid expansion on use of opioid agonist treatment and the role of provider capacity constraints10935
The Effect of Medicaid Policies on the Diagnosis and Treatment of Children's Mental Health Problems in Primary Care
Type: Journal Article
Year: 2015
Publication Place: England
Topic(s):
Healthcare Disparities
See topic collection
, Healthcare Policy
See topic collection
Reference Links:
View the DOI record for The Effect of Medicaid Policies on the Diagnosis and Treatment of Children's Mental Health Problems in Primary Care
View DOI Record
View the PubMed citation for The Effect of Medicaid Policies on the Diagnosis and Treatment of Children's Mental Health Problems in Primary Care10937
The effect of mental comorbidity on service delivery planning in primary care: an analysis with particular reference to patients who request referral without prior assessment
Type: Journal Article
Year: 2013
Publication Place: Germany
Abstract: BACKGROUND: In their everyday practice, primary-care physicians are often asked to refer patients to a specialist without a prior appointment in primary care. Such referrals are problematic, and one might suspect that patients who make such requests are more likely to have mental comorbidities predisposing them toward higher utilization of health-care services. METHODS: In a cross-sectional study, 307 patients of 13 primary-care practices who requested referral to a specialist without a prior appointment in primary care were given a Patient Health Questionnaire (PHQ) containing questions that related to depression, anxiety, panic disorder, and somatoform disorder (independent variables). Further information was obtained about these patients' primary-care contacts, referrals, and days taken off from work with a medical excuse over the course of one year (dependent variables). A regression model was used to compare these patients with 977 other primary-care patients. RESULTS: The groups of patients who did and did not request specialist referral without a primary-care appointment did not differ to any statistically significant extent with respect to mental comorbidity. In the overall group, somatoform disorder was found to be associated with a high rate of primary-care contacts (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.4-4.3). High rates of referral were strongly correlated (percentage of variance explained, R(2)) with depression (OR 2.1, 95% CI 1.1-4.0; R(2) = 35.3%), anxiety (OR 4.1, 95% CI 1.8-9.6; R(2) = 34.5%), panic disorder (OR 5.9, 95% CI 2.1-16.4; R(2) = 34.3%), and somatoform disorder (OR 2.2, 95% CI 1.2-4.0; R(2) = 34.6%). Taking a long time off from work with a medical excuse was correlated with depression (OR 2.5, 95% CI 1.2-4.8), anxiety (OR 4.2, 95% CI 1.7-10.5), and somatoform disorder (OR 2.2, 95% CI 1.2-4.2). CONCLUSION: Mental comorbidity contributes to the increased utilization of health-care services. This should be borne in mind whenever a patient requests many referrals to specialists (either with or without a prior appointment in primary care). It is important to identify "doctor-hopping" patients so that the causes of their behavior can be recognized, discussed, and properly treated.
Topic(s):
Medically Unexplained Symptoms
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