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Local Health Department Activities to Reduce Emergency Department Visits for Substance Use Disorders

Novak, Priscilla; Bloodworth, Robin; Green, Kerry; Chen, Jie

The Journal for Healthcare Quality (JHQ): May/June 2019 - Volume 41 - Issue 3 - p 134–145
doi: 10.1097/JHQ.0000000000000161
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ABSTRACT The Affordable Care Act (ACA) provides financial incentives to prevent substance use disorders (SUDs). Local health departments (LHDs) can receive funds to establish care teams that partner with primary care providers and health systems. This study estimates the potential effect of LHDs on emergency visits for SUDs, using linked data sets from the Healthcare Cost and Utilization Project Emergency Department (ED) sample for the State of Maryland—2012, the National Association of County and City Health Officials Profiles Survey 2013, and Area Health Resource File 2013 to estimate potential effect of LHDs' provision of SUD preventive care and SUD-related policy implementation. Local health department involvement in SUD-related policy during the past 2 years and provision of preventive care for behavioral health in the past year significantly reduced the probability of having a SUD-related ED visit by 11% and 6%, respectively, after controlling for individual characteristics (odds ratio [OR] = 0.89, p < .001; OR = 0.93, p < .001). After adjusting for the individual and contextual factors, LHD involvement in policy was still associated with 14% reduction in SUD-related ED visits (OR = 0.86, p < .001). Results offer insights on the extent to which the LHD activities can possibly affect SUD-related ED visits and provide a foundation for future work to identify effective LHD interventions.

For more information on this article, contact Priscilla Novak at pnovak1@umd.edu.

P. Novak wishes to disclose that she was an employee of the Agency for Healthcare Research and Quality (AHRQ) at the time the article was written. R. Bloodworth wishes to disclose that she is an employee of the Patient-Centered Outcomes Research Institute (PCORI). The opinions expressed in this manuscript are those of the authors and do not necessarily reflect the opinions or positions of AHRQ, PCORI, of the US Federal government. The remaining authors declare no conflicts of interest.

Funders: Dr. Jie Chen is funded by the National Institutes of Health, National Institute of Mental Health (R21MH106813); National Institute on Minority Health and Health Disparities (R01MD011523); and National Institute on Aging (R56AG062315).

© 2019 National Association for Healthcare Quality
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