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

2 Citations (Scopus)

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)
JournalSubstance Abuse
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Odds Ratio
Alcohols
Confidence Intervals
Delivery of Health Care
Pharmaceutical Preparations
Psychiatry
Datasets
African Americans
Primary Health Care
Outpatients
Logistic Models
Therapeutics
Asian Americans
Electronic Health Records
Health Insurance
Hispanic Americans
Hospital Emergency Service
Inpatients
Demography

Keywords

  • Alcohol and drug
  • performance measures

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

Weisner, C., Campbell, C. I., Altschuler, A., Yarborough, B. J. H., Lapham, G. T., Binswanger, I. A., ... Kline-Simon, A. H. (Accepted/In press). Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015. Substance Abuse. https://doi.org/10.1080/08897077.2018.1545728

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 journalArticle

Weisner, C, Campbell, CI, Altschuler, A, Yarborough, BJH, Lapham, GT, Binswanger, IA, Hechter, RC, Ahmedani, BK, Haller, IV, Sterling, SA, McCarty, D, Satre, DD & Kline-Simon, AH 2019, 'Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015' Substance Abuse. https://doi.org/10.1080/08897077.2018.1545728
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. / Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015. In: Substance Abuse. 2019.
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title = "Factors associated with Healthcare Effectiveness Data and Information Set (HEDIS) alcohol and other drug measure performance in 2014–2015",
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.",
keywords = "Alcohol and drug, performance measures",
author = "Constance Weisner and Campbell, {Cynthia I.} and Andrea Altschuler and Yarborough, {Bobbi Jo H.} and Lapham, {Gwen T.} and Binswanger, {Ingrid A.} and Hechter, {Rulin C.} and Ahmedani, {Brian K.} and Haller, {Irina V.} and Sterling, {Stacy A.} and Dennis McCarty and Satre, {Derek D.} and Kline-Simon, {Andrea H.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1080/08897077.2018.1545728",
language = "English (US)",
journal = "Substance Abuse",
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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

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