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. 2018 Feb;53(1):389-404.
doi: 10.1111/1475-6773.12686. Epub 2017 Mar 27.

Geographic Disparities in Availability of Opioid Use Disorder Treatment for Medicaid Enrollees

Amanda J Abraham  1 , Christina M Andrews  2 , Marissa E Yingling  3 , Jerry Shannon  4
Affiliations

Geographic Disparities in Availability of Opioid Use Disorder Treatment for Medicaid Enrollees

Amanda J Abraham et al. Health Serv Res. 2018 Feb.

Abstract

Objective: To examine county-level geographic variation in treatment admissions among opioid treatment programs (OTPs) that accept Medicaid in the continental United States.

Data sources/study setting: Data come from the 2012 National Survey of Substance Abuse Treatment Services.

Study design/data collection: We used local measures of spatial autocorrelation (LISA) analysis to identify (1) clusters of counties with higher and lower than average rates of opioid use disorders and (2) clusters of counties with higher and lower than average treatment admissions among OTPs that accept Medicaid, adjusting for county population size.

Principal findings: Our results reveal several clusters of counties with higher than average rates of opioid use disorder (OUD) and lower than average treatment admissions among OTPs that accept Medicaid. These clusters are highly concentrated in the Southeast region of the country and include Arkansas, Kentucky, Louisiana, Mississippi, and Tennessee.

Conclusions: Medicaid enrollees in areas in the Southeast have the largest gaps between county-level OUD rates and estimated county-level capacity for treatment, as measured by county-level total treatment admissions among OTPs that accept Medicaid. Policy makers should consider strategies to increase the availability of OTPs with the capacity to serve Medicaid enrollees.

Keywords: Medicaid; access; opioid treatment programs; opioid use disorder.

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Figures

Figure 1
Figure 1
Admissions to OTPs That Accept Medicaid Insurance per 1,000 Residents in the County [Color figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Rate of Opioid Use Disorders per 1,000 Residents, Weighted by County Opioid Overdose Death Rates [Color figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
The LISA Clusters: Rate of Opioid Use Disorders per 1,000 Residents in County, Rate of Admissions to OTPs That Accept Medicaid Insurance per 1,000 Residents in County, and Rate of Admissions to All OTPs per 1,000 Residents in the County [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

References

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    1. Andrews, C. , Abraham A., Grogan C. M., Pollack H. A., Bersamira C., Humphreys K., and Friedmann P.. 2015. “Despite Resources from the ACA, Most States Do Little to Help Addiction Treatment Programs Implement Health Care Reform.” Health Affairs (Millwood) 34 (5): 828–35. - PMC - PubMed
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    1. Berman, S. , Dolins J., Tang S. F., and Yudkowsky B.. 2002. “Factors That Influence the Willingness of Private Primary Care Pediatricians to Accept More Medicaid Patients.” Pediatrics 110 (2 Pt 1): 239–48. - PubMed

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