PDF(Pubmed)
Abstract：
UNASSIGNED: Transitions in insurance coverage may be associated with worse health care outcomes. Little is known about insurance stability for individuals with opioid use disorder (OUD).
UNASSIGNED: To examine insurance transitions among adults with newly diagnosed OUD in the 12 months after diagnosis.
UNASSIGNED: Longitudinal cohort study using data from the Massachusetts Public Health Data Warehouse. The cohort includes adults aged 18 to 63 years diagnosed with incident OUD between July 1, 2014, and December 31, 2014, who were enrolled in commercial insurance or Medicaid at diagnosis; individuals diagnosed after 2014 were excluded from the main analyses due to changes in the reporting of insurance claims. Data were analyzed from November 10, 2022, to May 6, 2024.
UNASSIGNED: Insurance type at time of diagnosis (commercial and Medicaid).
UNASSIGNED: The primary outcome was the cumulative incidence of insurance transitions in the 12 months after diagnosis. Logistic regression models were used to generate estimated probabilities of insurance transitions by insurance type and diagnosis for several characteristics including age, race and ethnicity, and whether an individual started medication for OUD (MOUD) within 30 days after diagnosis.
UNASSIGNED: There were 20 768 individuals with newly diagnosed OUD between July 1, 2014, and December 31, 2014. Most individuals with newly diagnosed OUD were covered by Medicaid (75.4%). Those with newly diagnosed OUD were primarily male (67% in commercial insurance, 61.8% in Medicaid). In the 12 months following OUD diagnosis, 30.4% of individuals experienced an insurance transition, with adjusted models demonstrating higher transition rates among those starting with Medicaid (31.3%; 95% CI, 30.5%-32.0%) compared with commercial insurance (27.9%; 95% CI, 26.6%-29.1%). The probability of insurance transitions was generally higher for younger individuals than older individuals irrespective of insurance type, although there were notable differences by race and ethnicity.
UNASSIGNED: This study found that nearly 1 in 3 individuals experience insurance transitions in the 12 months after OUD diagnosis. Insurance transitions may represent an important yet underrecognized factor in OUD treatment outcomes.
UNASSIGNED: To examine insurance transitions among adults with newly diagnosed OUD in the 12 months after diagnosis.
UNASSIGNED: Longitudinal cohort study using data from the Massachusetts Public Health Data Warehouse. The cohort includes adults aged 18 to 63 years diagnosed with incident OUD between July 1, 2014, and December 31, 2014, who were enrolled in commercial insurance or Medicaid at diagnosis; individuals diagnosed after 2014 were excluded from the main analyses due to changes in the reporting of insurance claims. Data were analyzed from November 10, 2022, to May 6, 2024.
UNASSIGNED: Insurance type at time of diagnosis (commercial and Medicaid).
UNASSIGNED: The primary outcome was the cumulative incidence of insurance transitions in the 12 months after diagnosis. Logistic regression models were used to generate estimated probabilities of insurance transitions by insurance type and diagnosis for several characteristics including age, race and ethnicity, and whether an individual started medication for OUD (MOUD) within 30 days after diagnosis.
UNASSIGNED: There were 20 768 individuals with newly diagnosed OUD between July 1, 2014, and December 31, 2014. Most individuals with newly diagnosed OUD were covered by Medicaid (75.4%). Those with newly diagnosed OUD were primarily male (67% in commercial insurance, 61.8% in Medicaid). In the 12 months following OUD diagnosis, 30.4% of individuals experienced an insurance transition, with adjusted models demonstrating higher transition rates among those starting with Medicaid (31.3%; 95% CI, 30.5%-32.0%) compared with commercial insurance (27.9%; 95% CI, 26.6%-29.1%). The probability of insurance transitions was generally higher for younger individuals than older individuals irrespective of insurance type, although there were notable differences by race and ethnicity.
UNASSIGNED: This study found that nearly 1 in 3 individuals experience insurance transitions in the 12 months after OUD diagnosis. Insurance transitions may represent an important yet underrecognized factor in OUD treatment outcomes.
摘要：
■保险范围的转变可能与更糟糕的医疗保健结果有关。人们对阿片类药物使用障碍（OUD）患者的保险稳定性知之甚少。
■检查诊断后12个月内新诊断为OUD的成年人的保险过渡。
■使用来自马萨诸塞州公共卫生数据仓库的数据进行纵向队列研究。该队列包括2014年7月1日至2014年12月31日之间被诊断患有OUD事件的18至63岁成年人，他们在诊断时参加了商业保险或医疗补助;由于保险索赔报告的变化，2014年以后诊断的个人被排除在主要分析之外。数据从2022年11月10日至2024年5月6日进行了分析。
■诊断时的保险类型（商业和医疗补助）。
■主要结果是诊断后12个月内保险过渡的累积发生率。Logistic回归模型被用来生成估计概率的保险过渡的保险类型和诊断的几个特征，包括年龄，种族和民族,以及个人是否在诊断后30天内开始服用OUD（MOUD）。
■2014年7月1日至2014年12月31日期间，有20768名新诊断的OUD患者。大多数新诊断为OUD的人都得到了医疗补助(75.4%)。那些新诊断为OUD的人主要是男性（商业保险中有67％，61.8%的医疗补助）。在OUD诊断后的12个月里，30.4%的人经历了保险转型，与商业保险(27.9%;95%CI,26.6%-29.1%)相比,调整后的模型在医疗补助(31.3%;95%CI,30.5%-32.0%)开始时具有更高的过渡率。与保险类型无关，年轻个体的保险转型概率通常高于年长个体，尽管种族和民族之间存在显着差异。
■这项研究发现，近三分之一的人在OUD诊断后的12个月内经历了保险过渡。保险过渡可能是OUD治疗结果中一个重要但未被认可的因素。
■检查诊断后12个月内新诊断为OUD的成年人的保险过渡。
■使用来自马萨诸塞州公共卫生数据仓库的数据进行纵向队列研究。该队列包括2014年7月1日至2014年12月31日之间被诊断患有OUD事件的18至63岁成年人，他们在诊断时参加了商业保险或医疗补助;由于保险索赔报告的变化，2014年以后诊断的个人被排除在主要分析之外。数据从2022年11月10日至2024年5月6日进行了分析。
■诊断时的保险类型（商业和医疗补助）。
■主要结果是诊断后12个月内保险过渡的累积发生率。Logistic回归模型被用来生成估计概率的保险过渡的保险类型和诊断的几个特征，包括年龄，种族和民族,以及个人是否在诊断后30天内开始服用OUD（MOUD）。
■2014年7月1日至2014年12月31日期间，有20768名新诊断的OUD患者。大多数新诊断为OUD的人都得到了医疗补助(75.4%)。那些新诊断为OUD的人主要是男性（商业保险中有67％，61.8%的医疗补助）。在OUD诊断后的12个月里，30.4%的人经历了保险转型，与商业保险(27.9%;95%CI,26.6%-29.1%)相比,调整后的模型在医疗补助(31.3%;95%CI,30.5%-32.0%)开始时具有更高的过渡率。与保险类型无关，年轻个体的保险转型概率通常高于年长个体，尽管种族和民族之间存在显着差异。
■这项研究发现，近三分之一的人在OUD诊断后的12个月内经历了保险过渡。保险过渡可能是OUD治疗结果中一个重要但未被认可的因素。
