How Does Telehealth Expansion Change Access to Healthcare for Patients With Different Types of Substance Use Disorders?

How Does Telehealth Expansion Change Access to Healthcare for Patients With Different Types of Substance Use Disorders?

Publication date: Mar 17, 2024

Patients with substance use disorders (SUDs) exhibit low healthcare utilization despite high medical need. Telehealth could boost utilization, but variation in uptake across SUDs is unknown. Using Wisconsin Medicaid enrollment and claims data from December 1, 2018, to December 31, 2020, we conducted a cohort study of telemedicine uptake in the all-ambulatory and the primary care setting during telehealth expansion following the COVID-19 public health emergency (PHE) onset (March 14, 2020). The sample included continuously enrolled (19 months), nonpregnant, nondisabled adults aged 19 to 64 years with opioid (OUD), alcohol (AUD), stimulant (StimUD), or cannabis (CannUD) use disorder or polysubstance use (PSU). Outcomes: total and telehealth visits in the week, and fraction of visits in the week completed by telehealth. Linear and fractional regression estimated changes in in-person and telemedicine utilization. We used regression coefficients to calculate the change in telemedicine utilization, the proportion of in-person decline offset by telemedicine uptake (“offset”), and the share of visits completed by telemedicine (“share”). The cohort (n = 16 756) included individuals with OUD (34. 8%), AUD (30. 1%), StimUD (9. 5%), CannUD (9. 5%), and PSU (19. 7%). Total and telemedicine utilization varied by group post-PHE. All-ambulatory: total visits dropped for all, then rose above baseline for OUD, PSU, and AUD. Telehealth expansion was associated with visit increases: OUD: 0. 489, P 

Concepts Keywords
Cannabis alcohol use disorder
December cannabis use disorder
Medicaid opioid use disorder
Wisconsin polysubstance use
stimulant use disorder
telehealth

Semantics

Type Source Name
disease MESH Substance Use Disorders
disease MESH COVID-19
disease MESH emergency
drug DRUGBANK L-Phenylalanine
drug DRUGBANK Ethanol
drug DRUGBANK Medical Cannabis
disease MESH alcohol use disorder
disease MESH opioid use disorder

Original Article

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