Impact of an opioid use disorder medication implementation intervention on hospitalization and emergency department utilization in the Veterans Health Administration

作者：Madeline C. Frost, Carol A. Malte, Amy J. Kennedy, Andrew J. Saxon, Adam J. Gordon, Hildi Hagedorn, Emily C. Williams, Ryan S. Trim, Aline Lott, Anissa N. Danner, Eric J. Hawkins · 发表于：BMC Psychiatry · 年份：2025 · DOI：10.1186/s12888-025-06722-6 · 被引用次数：4 · 研究领域：Opioid Use Disorder Treatment、Substance Abuse Treatment and Outcomes、HIV, Drug Use, Sexual Risk

BACKGROUND: It is important to evaluate how medication for opioid use disorder (MOUD) implementation interventions impact downstream outcomes, however little is known about impact on hospitalization and emergency department (ED) utilization. Stepped Care for Opioid Use Disorder Train the Trainer (SCOUTT) is a national United States Veterans Health Administration (VHA) effort initially implemented at 18 facilities that increased MOUD receipt in primary care, mental health, and pain clinics. This evaluation assessed SCOUTT's impact on hospitalization and ED utilization. METHODS: This evaluation used a controlled interrupted time series analysis. We extracted electronic health record data for patients with OUD and ≥ 1 visit in an intervention clinic (N = 35) or matched comparison clinic (N = 35) in the post-implementation year. We examined monthly measures of hospitalization and ED utilization in the pre-implementation (9/1/2017-8/31/2018) and post-implementation (9/1/2018-8/31/2019) years. Segmented regression models estimated pre-post immediate and trend changes in intervention relative to comparison clinics, adjusting for pre-implementation trends and patient characteristics. Sensitivity analyses were conducted among patients with ≥ 1 visit in both the pre-/post-implementation years, and post-hoc secondary analyses were conducted among patients with OUD and ≥ 1 other SUD vs. OUD only. RESULTS: Patients with OUD in both intervention (N = 7,488) and comparison (N = 7,558) clini...