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Retention on buprenorphine treatment reduces emergency department utilization,but not hospitalization,among treatment-seeking patients with opioid dependence
Authors:Ryan Schwarz  Alexei Zelenev  R. Douglas Bruce  Frederick L. Altice
Affiliation:1. Department of Medicine, Brigham and Women''s Hospital, Boston, MA, USA;2. Department of Medicine, Children''s Hospital of Boston, Boston, MA, USA;3. Yale University School of Medicine, New Haven, CT, USA;4. Yale University School of Public Health, New Haven, CT, USA
Abstract:Drug users are marginalized from typical primary care, often resulting in emergency department (ED) usage and hospitalization due to late-stage disease. Though data suggest methadone decreases such fragmented healthcare utilization (HCU), the impact of buprenorphine maintenance treatment (BMT) on HCU is unknown. Chart review was conducted on opioid dependent patients seeking BMT, comparing individuals (n = 59) who left BMT ≤ 7 days with those retained on BMT (n = 150), for ED use and hospitalization. Using negative binomial regressions, including comparison of time before BMT induction, ED utilization and hospitalization were assessed. Overall, ED utilization was 0.93 events per person year and was significantly reduced by BMT, with increasing time (retention) on BMT. BMT had no significant effect on hospitalizations or average length of stay.
Keywords:Buprenorphine   Methadone   Substance abuse   Opioid dependence   Healthcare utilization   Emergency department utilization   Hospitalization   Longitudinal cohort
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