Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015

Constance Weisner, Cynthia I. Campbell, Andrea Altschuler, Bobbi Jo H. Yarborough, Gwen T. Lapham, Ingrid A. Binswanger, Rulin C. Hechter, Brian K. Ahmedani, Irina V. Haller, Stacy A. Sterling, Dennis McCarty, Derek D. Satre, Andrea H. Kline-Simon

Research output: Contribution to journalArticle

3 Scopus citations

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 languageEnglish (US)
Pages (from-to)318-327
Number of pages10
JournalSubstance Abuse
Volume40
Issue number3
DOIs
StatePublished - Jul 3 2019

Keywords

  • Alcohol and drug
  • performance measures

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

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    Weisner, C., Campbell, C. I., Altschuler, A., Yarborough, B. J. H., Lapham, G. T., Binswanger, I. A., Hechter, R. C., Ahmedani, B. K., Haller, I. V., Sterling, S. A., McCarty, D., Satre, D. D., & Kline-Simon, A. H. (2019). Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015. Substance Abuse, 40(3), 318-327. https://doi.org/10.1080/08897077.2018.1545728