退役軍人の間でオピオイド使用障害の治療に使用される医薬品の処方量を増加させるための外部支援プログラムの実施に関連する医療費
Aryan Esmaeili1, Hildi J Hagedorn2,3, Carla C Garcia1
1Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.
Substance use & addiction journal
|September 6, 2025
まとめ
ADaPT- OUD試験は,オピオイド使用障害 (OUD) の患者の全般的な医療費を有意に変化させなかった. しかし,それはより少ない非VAサービス遭遇とより高い外来精神科費用をもたらし,精神保健医療へのアクセスを改善することを示唆しました.
科学分野:
- 医療サービス研究
- 公衆衛生
- 臨床試験
背景:
- オピオイド使用障害 (Opioid Use Disorder,OUD) は公衆衛生上の重大な危機を 引き起こしています
- オピオイド使用障害 (MOUD) の薬は治療に不可欠です.
- 退役軍人保健局 (VHA) の施設でMOUDの処方率が低いため,介入が必要となった.
研究 の 目的:
- 退役軍人の医療費を評価する
- ADaPT-OUD 外部支援試験の経済的影響を評価する.
主な方法:
- 差異の違い (DID) 設計を使用した.
- 医療費の比較 (全額,外来,入院) 介入前と後の12ヶ月
- 7348人の退役軍人の OUDやMOUDの処方箋を分析した.
主要な成果:
- 医療費全体に重大な影響はない.
- 非VAサービスが減少したため,介入現場での接触が4%減少した.
- 退役軍人の精神科の診療費が 391 ドル増えました
結論:
- 精神科の外科医の診療費の増加は 精神保健サービスへのアクセスを拡大した結果かもしれません
- OUD治療へのアクセスを改善することで,併発性疾患の総合的なケアが容易になります.
- 外部支援は,OUDとメンタルヘルスの統合ケアを改善する可能性を示している.
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