PDF(Pubmed)
Abstract：
Integration of medication-assisted treatment (MAT) for opioid use disorder in primary care settings is an emerging health care delivery model that supports increased access to specialized care but requires primary care provider engagement. Examining the characteristics of providers who provide this service is key to informing targeted recruitment. Using administrative and supplemental data collected during license renewal, this study aimed to identify the characteristics of primary care physicians and nurse practitioners (NPs) associated with greater odds of providing MAT in their practice. A retrospective observational study was conducted using a descriptive correlational design. The analysis included 5259 physicians and 3486 NPs who renewed their licenses electronically in 2021 and specialized in primary care or psychiatry. Chi-square and logistic regression analyses were conducted to identify the demographic and clinical characteristics of physicians and NPs associated with MAT participation in their practice. Physicians had a higher odds ratio (OR) of providing MAT if they were younger than 35 years (OR = 1.334; P = .0443), practiced in a federally qualified health center (OR = 3.101, P < .0001), and offered a sliding fee scale in their practice (OR = 2.046; P < .0001). Likewise, NPs had higher odds of providing MAT if they practiced in a public or community health center (OR = 3.866; P < .0001). The results of this study highlight the personal and professional characteristics of physicians and NPs associated with higher odds of providing MAT. These findings may have implications for the recruitment and sustainability of MAT integration in primary care.
摘要：
在初级保健环境中整合阿片类药物使用障碍的药物辅助治疗（MAT）是一种新兴的医疗保健提供模式，它支持更多获得专门护理的机会，但需要初级保健提供者的参与。检查提供此服务的提供者的特征是告知有针对性的招聘的关键。使用许可证续订期间收集的管理和补充数据，本研究旨在确定初级保健医师和执业护士(NPs)的特征与在其实践中提供MAT的几率更大相关.使用描述性相关设计进行回顾性观察研究。分析包括5259名医生和3486名NPs，他们在2021年以电子方式续签了执照，专门从事初级保健或精神病学。进行卡方和逻辑回归分析，以确定与MAT参与其实践相关的医师和NPs的人口统计学和临床特征。如果医生年龄小于35岁，医生提供MAT的优势比（OR）更高（OR=1.334；P=.0443），在联邦合格的健康中心执业（OR=3.101，P<0.0001），并在他们的实践中提供了一个滑动的收费表(OR=2.046；P<0.0001)。同样，如果NPs在公共或社区卫生中心执业，他们提供MAT的几率更高(OR=3.866;P<.0001)。这项研究的结果突出了医生和NPs的个人和职业特征，这些特征与提供MAT的可能性更高有关。这些发现可能对初级保健中MAT整合的招募和可持续性产生影响。
