Abstract
Background: Only 10% of patients with alcohol and other drug (AOD) disorders receive treatment. The AOD Initiation and Engagement in Treatment (AOD-IET) measure was added to the national Healthcare Effectiveness Data and Information Set (HEDIS) to improve access to care. This study identifies factors related to improving AOD-IET rates. Methods: We include data from 7 health systems with differing geographic, patient demographic, and organizational characteristics; all used a common Virtual Data Warehouse containing electronic health records and insurance claims data. Multilevel logistic regression models examined AOD-IET among adults (18+). Results: A total of 86,565 patients had an AOD diagnosis qualifying for the HEDIS denominator. Initiation rates varied from 26% to 46%; engagement rates varied from 14% to 29%. Women versus men (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.76–0.86); Hispanics (OR = 0.85, 95% CI = 0.79–0.91), black/African Americans (OR = 0.82, 95% CI = 0.75–0.90), and Asian Americans (OR = 0.83, 95% CI = 0.72–0.95) versus whites; and patients aged 65+ versus 18–29 (OR = 0.82, 95% CI = 0.74–0.90) had lower odds of initiation. Patients aged 30–49 versus 18–29 (OR = 1.11, 95% CI = 1.04–1.19) and those with prior psychiatric (OR = 1.26, 95% CI = 1.18–1.35) and medical (OR = 1.18, 95% CI = 1.10–1.26) conditions had higher odds of engagement. Identification in primary care versus other departments was related to lower odds of initiation (emergency department [ED]: OR = 1.55, 95% CI = 1.45–1.66; psychiatry/AOD treatment: OR = 3.58, 95% CI = 3.33–3.84; other outpatient: OR = 1.19, 95% CI = 1.06–1.32). Patients aged 30–49 versus 18–29 had higher odds of engagement (OR = 1.26, 95% CI = 1.10–1.43). Patients aged 65+ versus 18–29 (OR = 0.51, 95% CI = 0.43–0.62) and black/African Americans versus whites (OR = 0.64, 95% CI = 0.53–0.77) had lower odds. Those initiating treatment in psychiatry/AOD treatment versus primary care (OR = 7.02, 95% CI = 5.93–8.31) had higher odds of engagement; those in inpatient (OR = 0.40, 95% CI = 0.32–0.50) or other outpatient (OR = 0.73, 95% CI = 0.59–0.91) settings had lower odds. Discussion: Rates of initiation and engagement varied but were low. Findings identified age, race/ethnicity, co-occurring conditions, and department of identification as key factors associated with AOD-IET. Focusing on these could help programs develop interventions that facilitate AOD-IET for those less likely to receive care.
| Original language | English (US) |
|---|---|
| Journal | Substance Abuse |
| DOIs | |
| State | Accepted/In press - Jan 1 2019 |
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Keywords
- Alcohol and drug
- performance measures
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Psychiatry and Mental health
Cite this
Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015. / Weisner, Constance; Campbell, Cynthia I.; Altschuler, Andrea; Yarborough, Bobbi Jo H.; Lapham, Gwen T.; Binswanger, Ingrid A.; Hechter, Rulin C.; Ahmedani, Brian K.; Haller, Irina V.; Sterling, Stacy A.; McCarty, Dennis; Satre, Derek D.; Kline-Simon, Andrea H.
In: Substance Abuse, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015
AU - Weisner, Constance
AU - Campbell, Cynthia I.
AU - Altschuler, Andrea
AU - Yarborough, Bobbi Jo H.
AU - Lapham, Gwen T.
AU - Binswanger, Ingrid A.
AU - Hechter, Rulin C.
AU - Ahmedani, Brian K.
AU - Haller, Irina V.
AU - Sterling, Stacy A.
AU - McCarty, Dennis
AU - Satre, Derek D.
AU - Kline-Simon, Andrea H.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Only 10% of patients with alcohol and other drug (AOD) disorders receive treatment. The AOD Initiation and Engagement in Treatment (AOD-IET) measure was added to the national Healthcare Effectiveness Data and Information Set (HEDIS) to improve access to care. This study identifies factors related to improving AOD-IET rates. Methods: We include data from 7 health systems with differing geographic, patient demographic, and organizational characteristics; all used a common Virtual Data Warehouse containing electronic health records and insurance claims data. Multilevel logistic regression models examined AOD-IET among adults (18+). Results: A total of 86,565 patients had an AOD diagnosis qualifying for the HEDIS denominator. Initiation rates varied from 26% to 46%; engagement rates varied from 14% to 29%. Women versus men (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.76–0.86); Hispanics (OR = 0.85, 95% CI = 0.79–0.91), black/African Americans (OR = 0.82, 95% CI = 0.75–0.90), and Asian Americans (OR = 0.83, 95% CI = 0.72–0.95) versus whites; and patients aged 65+ versus 18–29 (OR = 0.82, 95% CI = 0.74–0.90) had lower odds of initiation. Patients aged 30–49 versus 18–29 (OR = 1.11, 95% CI = 1.04–1.19) and those with prior psychiatric (OR = 1.26, 95% CI = 1.18–1.35) and medical (OR = 1.18, 95% CI = 1.10–1.26) conditions had higher odds of engagement. Identification in primary care versus other departments was related to lower odds of initiation (emergency department [ED]: OR = 1.55, 95% CI = 1.45–1.66; psychiatry/AOD treatment: OR = 3.58, 95% CI = 3.33–3.84; other outpatient: OR = 1.19, 95% CI = 1.06–1.32). Patients aged 30–49 versus 18–29 had higher odds of engagement (OR = 1.26, 95% CI = 1.10–1.43). Patients aged 65+ versus 18–29 (OR = 0.51, 95% CI = 0.43–0.62) and black/African Americans versus whites (OR = 0.64, 95% CI = 0.53–0.77) had lower odds. Those initiating treatment in psychiatry/AOD treatment versus primary care (OR = 7.02, 95% CI = 5.93–8.31) had higher odds of engagement; those in inpatient (OR = 0.40, 95% CI = 0.32–0.50) or other outpatient (OR = 0.73, 95% CI = 0.59–0.91) settings had lower odds. Discussion: Rates of initiation and engagement varied but were low. Findings identified age, race/ethnicity, co-occurring conditions, and department of identification as key factors associated with AOD-IET. Focusing on these could help programs develop interventions that facilitate AOD-IET for those less likely to receive care.
AB - Background: Only 10% of patients with alcohol and other drug (AOD) disorders receive treatment. The AOD Initiation and Engagement in Treatment (AOD-IET) measure was added to the national Healthcare Effectiveness Data and Information Set (HEDIS) to improve access to care. This study identifies factors related to improving AOD-IET rates. Methods: We include data from 7 health systems with differing geographic, patient demographic, and organizational characteristics; all used a common Virtual Data Warehouse containing electronic health records and insurance claims data. Multilevel logistic regression models examined AOD-IET among adults (18+). Results: A total of 86,565 patients had an AOD diagnosis qualifying for the HEDIS denominator. Initiation rates varied from 26% to 46%; engagement rates varied from 14% to 29%. Women versus men (odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.76–0.86); Hispanics (OR = 0.85, 95% CI = 0.79–0.91), black/African Americans (OR = 0.82, 95% CI = 0.75–0.90), and Asian Americans (OR = 0.83, 95% CI = 0.72–0.95) versus whites; and patients aged 65+ versus 18–29 (OR = 0.82, 95% CI = 0.74–0.90) had lower odds of initiation. Patients aged 30–49 versus 18–29 (OR = 1.11, 95% CI = 1.04–1.19) and those with prior psychiatric (OR = 1.26, 95% CI = 1.18–1.35) and medical (OR = 1.18, 95% CI = 1.10–1.26) conditions had higher odds of engagement. Identification in primary care versus other departments was related to lower odds of initiation (emergency department [ED]: OR = 1.55, 95% CI = 1.45–1.66; psychiatry/AOD treatment: OR = 3.58, 95% CI = 3.33–3.84; other outpatient: OR = 1.19, 95% CI = 1.06–1.32). Patients aged 30–49 versus 18–29 had higher odds of engagement (OR = 1.26, 95% CI = 1.10–1.43). Patients aged 65+ versus 18–29 (OR = 0.51, 95% CI = 0.43–0.62) and black/African Americans versus whites (OR = 0.64, 95% CI = 0.53–0.77) had lower odds. Those initiating treatment in psychiatry/AOD treatment versus primary care (OR = 7.02, 95% CI = 5.93–8.31) had higher odds of engagement; those in inpatient (OR = 0.40, 95% CI = 0.32–0.50) or other outpatient (OR = 0.73, 95% CI = 0.59–0.91) settings had lower odds. Discussion: Rates of initiation and engagement varied but were low. Findings identified age, race/ethnicity, co-occurring conditions, and department of identification as key factors associated with AOD-IET. Focusing on these could help programs develop interventions that facilitate AOD-IET for those less likely to receive care.
KW - Alcohol and drug
KW - performance measures
UR - http://www.scopus.com/inward/record.url?scp=85060719618&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060719618&partnerID=8YFLogxK
U2 - 10.1080/08897077.2018.1545728
DO - 10.1080/08897077.2018.1545728
M3 - Article
JO - Substance Abuse
JF - Substance Abuse
SN - 0889-7077
ER -