Association Between Process Based Quality Indicators and Mortality for Patients With Substance Use Disorders

Paddock, Susan M.; Hepner, Kimberly A.; Hudson, Teresa J.; Ounpraseuth, Songthip; Schrader, Amy; Sullivan, Greer; Watkins, Katherine E.

doi:10.15288/jsad.2017.78.588

Cited by 22 publications

(12 citation statements)

References 35 publications

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“…The few studies examining the link between utilization and mortality suggest that more service use could increase the receipt of preventive health services as well the early identification and management of new or worsening physical health problems (Druss et al, 2001; Meyer et al, 2014; Paddock et al, in press; Ronan and Herzig, 2016; Watkins et al, 2016). We found that frequent physician monitoring was associated with decreased mortality.…”

Section: Discussionmentioning

confidence: 99%

Association between process measures and mortality in individuals with opioid use disorders

Watkins

Paddock

Hudson

et al. 2017

Drug and Alcohol Dependence

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Background Individuals with opioid use disorders have high rates of mortality relative to the general population. The relationship between treatment process and mortality is unknown. Aim To examine the association between 7 process measures and 12- and 24-month mortality. Methods Retrospective cohort study of patients with opioid use disorders who received care from the Veterans Administration between October 2006 and September 2007. Logistic regression models were used to examine the association between 12 and 24-month mortality and 7 patient-level process measures, while risk-adjusting for patient characteristics. Process measures included quarterly physician visits, any opioid use disorder pharmacotherapy, continuous pharmacotherapy, psychosocial treatment, Hepatitis B/C and HIV screening, and no prescriptions for benzodiazepines or opioids. We conducted sensitivity analyses to examine the robustness of our findings to an unobserved confounder. Results Among individuals with opioid use disorders, not being prescribed opioids or benzodiazepines, receipt of any psychosocial treatment and quarterly physician visits were significantly associated with lower mortality at both 12 and 24 months, but Hepatitis and HIV screening, and measures related to opioid use disorder pharmacotherapy were not. Sensitivity analyses indicated that the difference in the prevalence of an unobserved confounder would have to be unrealistically large given the observed data, or there would need to be a large effect of the confounder, to render these findings non-significant. Conclusions And Relevance This is the first study to show an association between process measures and mortality in patients with opioid use disorders and provides initial evidence for their use as quality measures.

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Section: Discussionmentioning

confidence: 99%

Association between process measures and mortality in individuals with opioid use disorders

Watkins

Paddock

Hudson

et al. 2017

Drug and Alcohol Dependence

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“…Initiation and engagement have been endorsed by the National Quality Forum as reliable and valid quality measures. Research has shown that initiation and engagement in substance use disorder treatment is associated with lower criminal justice involvement, unemployment, and mortality (3)(4)(5)(6)(7)(8).…”

Section: Highlightsmentioning

confidence: 99%

Access to and Engagement in Substance Use Disorder Treatment Over Time

Liu

Storfer‐Isser

Mark

et al. 2020

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“…To achieve this objective, MODRN-OUD identified 20 access, quality and outcome measures and constructed these measures using the MODRN analytic approach outlined above. A number of sources were consulted to identify potential measures for inclusion: 1) a 2017 CMS guidance to State Medicaid Directors outlining indicators of access to high-quality OUD treatment [19], 2) a comprehensive review of over 20 medication-assisted treatment guidelines (and associated quality measures) performed for the US Department of Health and Human Services in 2015 [20], 3) American Society of Addiction Medicine (ASAM) guidlines [21], and 4) the peer-reviewed literature [222324252627]. MODRN-OUD findings point to significant variation in the prevalence of OUD, and in access and quality of treatment for OUD across state Medicaid programs.…”

Section: Modrn – Opioid Use Disordermentioning

confidence: 99%

Innovative Solutions for State Medicaid Programs to Leverage Their Data, Build Their Analytic Capacity, and Create Evidence-Based Policy

Adams¹,

Kennedy²,

Allen³

et al. 2019

eGEMs

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As states have embraced additional flexibility to change coverage of and payment for Medicaid services, they have also faced heightened expectations for delivering high-value care. Efforts to meet these new expectations have increased the need for rigorous, evidence-based policy, but states may face challenges finding the resources, capacity, and expertise to meet this need. By describing state-university partnerships in more than 20 states, this commentary describes innovative solutions for states that want to leverage their own data, build their analytic capacity, and create evidence-based policy. From an integrated web-based system to improve long-term care to evaluating the impact of permanent supportive housing placements on Medicaid utilization and spending, these state partnerships provide significant support to their state Medicaid programs. In 2017, these partnerships came together to create a distributed research network that supports multi-state analyses. The Medicaid Outcomes Distributed Research Network (MODRN) uses a common data model to examine Medicaid data across states, thereby increasing the analytic rigor of policy evaluations in Medicaid, and contributing to the development of a fully functioning Medicaid innovation laboratory.

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Association Between Process Based Quality Indicators and Mortality for Patients With Substance Use Disorders

Cited by 22 publications

References 35 publications

Association between process measures and mortality in individuals with opioid use disorders

Association between process measures and mortality in individuals with opioid use disorders

Access to and Engagement in Substance Use Disorder Treatment Over Time

Innovative Solutions for State Medicaid Programs to Leverage Their Data, Build Their Analytic Capacity, and Create Evidence-Based Policy

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