通过个人车辆与公共交通工具前往甲治疗的旅行时间
Benjamin A Howell1,2, Junghwan Kim3, Thomas A Thornhill4,5
1Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
JAMA network open
|February 3, 2026
概括
公共交通工具前往阿片类药物治疗计划 (OTP) 的旅行时间比个人车辆的旅行时间要长得多,这阻碍了美沙治疗的准入. 需要改变政策来减少这些基于旅行的障碍.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 地理空间分析是什么
背景情况:
- 每天参加阿片类药物治疗计划 (OTPs) 对接受美沙的患者来说是旅行时间障碍.
- 现有的关于美沙可访问性的研究往往忽略了公共交通,主要关注个人车辆旅行.
研究的目的:
- 估计和比较通过个人车辆与公共交通工具到康涅狄格州最近的甲治疗OTP的中位数旅行时间.
- 确定与公共交通运输到OTP的行程时间相关的社会人口统计因素.
主要方法:
- 从所有康涅狄格州的人口普查区组 (CBGs) 到最近的OTP的中位旅行时间的横截面地理空间分析.
- 利用空间错误模型与k-最近邻近的空间重量矩阵来评估CBG特征和旅行时间之间的关联.
- 根据人口统计,收入,汽车所有权,城乡划分以及过量死亡率来表征CBG.
主要成果:
- 乘坐个人车辆到达最近的OTP的平均行程时间为11.0分钟,乘坐公共交通工具则为41.7分钟.
- 超过一半的CBG (53%) 有限或没有公共交通接入OTP (行程>60分钟).
- 随着城市-农村梯度和非西班牙裔白人居民比例的增加,公共交通运输的旅行时间增加了;高过量率的地区也显示出显著的公共交通障碍.
结论:
- 公共交通运输的长途旅行时间和有限的通道是甲治疗的重大障碍,特别是在过量使用率高的地区.
- 对于基于旅行的进入障碍的地区,建议采取移动服务或增加带回家的甲剂量的干预措施.
- 目前的联邦法规要求频繁的亲自出席是主要障碍,需要改革政策以改善甲的可访问性.
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