2021
DOI: 10.1080/08897077.2020.1803176
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Geographic Differences in Receipt of Addictions Treatment in a National Sample of Patients with Alcohol use Disorders from the U.S. Veterans Health Administration

Abstract: Background: In the United States, alcohol use disorder (AUD) is common and costly but substantially undertreated. Rurality is an important determinant of health that may influence receipt of evidence-based alcohol-related care. In a large, national sample of Veterans Health Administration (VA) patients with AUD with documented and non-Hispanic Black, Hispanic, or non-Hispanic White race/ethnicity, we examine whether meeting national Healthcare Effectiveness Data and Information Set (HEDIS) quality measures for… Show more

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Cited by 15 publications
(8 citation statements)
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“…This was amplified for clinicians who practiced in rural settings who noted limited access to specialized care, including behavioral therapy. These findings are congruent with the literature which notes significant differences in the treatment of patients for AUD in rural and urban settings [ 12 , 51 54 ]. Though it may not be feasible to increase rural access to supports for patients with AUD, an increased awareness and visibility of processes to access these supports for both specialists and PCPs will no doubt benefit patients with AUD and cirrhosis.…”
Section: Discussionsupporting
confidence: 91%
“…This was amplified for clinicians who practiced in rural settings who noted limited access to specialized care, including behavioral therapy. These findings are congruent with the literature which notes significant differences in the treatment of patients for AUD in rural and urban settings [ 12 , 51 54 ]. Though it may not be feasible to increase rural access to supports for patients with AUD, an increased awareness and visibility of processes to access these supports for both specialists and PCPs will no doubt benefit patients with AUD and cirrhosis.…”
Section: Discussionsupporting
confidence: 91%
“…Les personnes vivant en milieu rural sont moins susceptibles que les citadins de subir un dépistage concernant la consommation d’alcool (RC 0,15, IC de 95 % 0,14–0,16), d’être renseignés à ce sujet (RC 0,15, IC de 95 % 0,14–0,17) ou de recevoir des conseils appropriés (RC 0,08, IC de 95 % 0,06–0,09) après un dépistage positif 166 . En milieu rural, on observe aussi moins de traitements instaurés (RC 0,88, IC de 95 % 0,83–0,93; n = 52 165), d’observance thérapeutique (RC 0,86, IC de 95 % 0,77–0,97; n = 14 114) et de médicaments prescrits (RC 0,83, IC de 95 % 0,73–0,94; n = 15 062) qu’en milieu urbain 167 . Parmi les adultes de 65 ans ou plus ( n = 9663), les femmes sont plus susceptibles que les hommes d’affirmer avoir fait l’objet d’un dépistage de leur consommation d’alcool (risque relatif 1,22, IC de 95 % 1,05–1,42), mais moins susceptibles d’aborder le sujet avec leurs médecins (risque relatif 0,82, IC de 95 % 0,73–0,91) 168 .…”
Section: Consommation De Substancesunclassified
“…Studies of veterans find similar disparities, such that those in rural areas are less likely to receive treatment for alcohol-related concerns. Veterans in rural areas were 17% less likely than veterans in urban areas to receive evidence-based medications for alcohol use disorder (AUD) [ 17 ]. In another study, rural veterans were less likely than urban or suburban dwelling veterans to receive an alcohol screening at medical checkups [ 18 ].…”
Section: Introductionmentioning
confidence: 99%
“…Definitions of problematic alcohol use tended to involve a high level of distress or impairment in these communities, with individuals identifying legal problems, causing others harm, and performing poorly at work or neglecting family responsibilities as the main signs someone has a problem with alcohol [ 20 ••]. Among veterans with a positive AUD screen, those residing in rural areas were 12% less likely to initiate treatment and 14% less likely to meet engagement criteria if they did initiate services [ 17 ]. Therefore, rural individuals may have a higher threshold for recognizing a need for alcohol treatment.…”
Section: Introductionmentioning
confidence: 99%