Evidence map›Paper›PMID 35135988›Full record

ArticleJournal of addiction medicine

Expanding Inpatient Addiction Consult Services Through Accountable Care Organizations for Medicaid Enrollees: A Modeling Study.

Caroline A King, Ryan Cook, P Todd Korthuis, Dennis McCarty, Cynthia D Morris, Honora Englander

Open access · greenAbstract read
In one paragraph

Article in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Caroline A KingFrom the Department of Biomedical Engineering, School of Medicine, Oregon Health & Science University, Portland, OR (CAK); Department of Medicine, Section of Addiction Medicine, Oregon Health & Science University, Portland, OR (RC, PTK, HE); School of Public Health, Oregon Health & Science University - Portland State University, Portland, OR (DM); Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR (CDM); Department of Medicine, Division of Hospital Medicine, Oregon Health & Science University, Portland, OR (HE).
Ryan Cook
P Todd Korthuis
Dennis McCarty
Cynthia D Morris
Honora Englander
Children’s Discovery Museum of San Jose · US

Funding

Oregon Clinical and Translational Research Institute - The National COVID Cohort Collaborative (N3C)UL1TR002369 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI Cynthia D Morris, Christopher G. Slatore · 2017 to 2026
$78.4M
Western States Node of the National Drug Abuse Treatment Clinical Trials NetworkU10DA015815 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MCCARTY, DENNIS, SORENSEN, JAMES L · 2002 to 2015
$25.2M
Western States Node of the National Drug Abuse Treatment Clinical Trials Network (TMS for CUD) UG1DA015815 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Keith N. Humphreys, Philip Todd Korthuis · 2015 to 2026
$24.6M
Oregon Clinical and Translational Research Institute TL1 ProgramTL1TR002371 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI ALLISON Deborah FRYER, JESSINA C MCGREGOR · 2017 to 2026
$6.2M
Oregon HIV/Hepatitis and Opioid Prevention and Engagement (OR-HOPE) Study Cost ExtensionUH3DA044831 · NIDA · OREGON HEALTH & SCIENCE UNIVERSITY · PI KORTHUIS, PHILIP TODD · 2019 to 2022
$4.0M
Modeling the impact of hospital-based addiction consult services on post-discharge mortalityF30DA052972 · NIDA · OREGON HEALTH & SCIENCE UNIVERSITY · PI KING, CAROLINE · 2021 to 2021
$36k
NCATS NIH HHS TL1 TR002371NCATS NIH HHS UL1 TR002369NIDA NIH HHS F30 DA052972NIDA NIH HHS U10 DA015815NIDA NIH HHS UG1 DA015815NIDA NIH HHS UH3 DA044831
6 · The paper itself

Abstract

introductionAddiction consult services (ACS) care for hospitalized patients with substance use disorder, including opioid use disorder (OUD). Medicaid Accountable Care Organizations (ACOs) could enhance access to ACS. This study extends data from Oregon's only ACS to Oregon's 15 regional Medicaid Coordinated Care Organizations (CCOs) to illustrate the potential value of enhanced in- and out-patient care for hospitalized patients with OUD. The study objectives were to estimate the effects of (1) expanding ACS care through CCOs in Oregon, and (2) increasing community treatment access within CCOs, on post-discharge OUD treatment engagement.

methodsWe used a validated Markov model, populated with Oregon Medicaid data from April 2015 to December 2017, to estimate study objectives.

resultsOregon Medicaid patients hospitalized with OUD with care billed to a CCO (n = 5878) included 1298 (22.1%) patients engaged in post-discharge OUD treatment. Simulation of referral to an ACS increased post-discharge OUD treatment engagement to 47.0% (95% confidence interval [CI] 45.7%, 48.3%), or 2684 patients (95% CI 2610, 2758). Ten of fifteen (66.7%) CCOs had fewer than 20% of patients engage in post-discharge OUD care. Without ACS, increasing outpatient treatment such that 20% of patients engage increased the patients engaging in post-discharge OUD care from 12.9% or 296 patients in care at baseline to 20% (95% CI 18.1%, 21.4%) or 453 (95% CI 416, 491). DISCUSSION: ACOs can improve care for patients hospitalized with OUD. Implementing ACS in ACO networks can potentially improve post-discharge OUD treatment engagement, but community treatment systems must be prepared to accept more patients as inpatient addiction care improves.

Indexed as

Accountable Care OrganizationsOpioid-Related DisordersAftercareHumansInpatientsMedicaidPatient DischargeReferral and ConsultationUnited States

Identifiers

PMID35135988
PMCPMC9357852
OpenAlexW4210832234

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.