ArticleHealth services research2024
Rural-urban differences in out-of-network treatment initiation and engagement rates for substance use disorders.
Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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.
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Who cites it
9 citing papers in PubMed.
- Provider Perspectives on a Tobacco-Free Workplace Program in Healthcare Settings Serving Rural and Medically Underserved Areas of Texas: A Mixed Methods Study on Perceived Resource Availability and Value.International journal of environmental research and public health · 2026Article
- Drug therapy problems among pediatric patients with infectious diseases admitted to Debre Birhan Hakim Gizaw teaching hospital in Ethiopia.Scientific reports · 2026Article
- County-level vulnerability is associated with mental health and substance use treatment among rural suicide decedents: A national multi-year cross-sectional study.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Regional disparities in Japanese children's mental health profession shortage areas.PCN reports : psychiatry and clinical neurosciences · 2025Review
- Rural-urban differences in substance use during pregnancy.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- "I'm tired of seeing my friends die": Barriers and facilitators to participating in clinical trials among rural people who use drugs in the United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Predictors of Patient Engagement in a Care Coordination Program.Patient preference and adherence · 2025Article
- Rural-urban differences in out-of-network treatment initiation and engagement rates for substance use disorders.Health services research · 2024Article
- Analyzing and predicting short-term substance use behaviors of persons who use drugs in the great plains of the U.S.PloS one · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine rural-urban disparities in substance use disorder treatment access and continuation. DATA SOURCES AND STUDY
settingWe analyzed a 2016-2018 U.S. national secondary dataset of commercial insurance claims. STUDY
designThis cross-sectional study examined individuals with a new episode of opioid, alcohol, or other drug use disorders. Treatment initiation and engagement rates, and rates of using out-of-network providers for these services, were compared between rural and urban patients. DATA COLLECTION: We included individuals 18-64 years old with continuous employer-sponsored insurance. PRINCIPAL
findingsPatients in rural settings experienced lower treatment initiation rates for alcohol (36.6% vs. 38.0%, p < 0.001), opioid (41.2% vs. 44.2%, p < 0.001), and other drug (37.7% vs. 40.1%, p < 0.001) use disorders, relative to those in urban areas. Similarly, rural patients had lower treatment engagement rates for alcohol (15.1% vs. 17.3%, p < 0.001), opioid (21.0% vs. 22.6%, p < 0.001), and other drug (15.5% vs. 17.5%, p < 0.001) use disorders. Rural patients had higher out-of-network rates for treatment initiation for other drug use disorders (20.4% vs. 17.2%, p < 0.001), and for treatment engagement for alcohol (27.6% vs. 25.2%, p = 0.006) and other drug (36.1% vs. 31.1%, p < 0.001) use disorders.
conclusionsThese findings indicate that individuals with substance use disorders in rural areas have lower rates of initial and ongoing treatment, and are more likely to seek care out-of-network.
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