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The Treatment of Oxycodone Abuse: Organizational Predictors of Admissions

The Treatment of Oxycodone Abuse: Organizational Predictors of Admissions. Hannah K. Knudsen Lori J. Ducharme J. Aaron Johnson Paul M. Roman The University of Georgia http://www.uga.edu/ntcs

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The Treatment of Oxycodone Abuse: Organizational Predictors of Admissions

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  1. The Treatment of Oxycodone Abuse:Organizational Predictors of Admissions Hannah K. Knudsen Lori J. Ducharme J. Aaron Johnson Paul M. Roman The University of Georgia http://www.uga.edu/ntcs The authors acknowledge the support of the National Institute on Drug Abuse (R01DA14482 & R01DA13110) The University of Georgia

  2. Trends in Non-Medical Use of Controlled Release (CR) Oxycodone • Several data sources suggest that non-medical use of CR-oxycodone is increasing • Increased use in National Household Survey on Drug Use & Health between 2002 - 2003 • Increased use among adolescents between 2002 - 2004 in Monitoring the Future data • More frequent mentions in DAWN emergency room data • Some researchers have begun to consider the characteristics of individuals who seek treatment for CR-oxycodone abuse/dependence • There is virtually no national data on the characteristics of treatment organizations that are serving these clients The University of Georgia

  3. Treatment-Seeking for Oxycodone Abuse: The Relevance of Organizations • Understanding the types of individuals who seek treatment is only part of the health services question • It is critical to consider the characteristics of settings from which clients seek treatment for oxycodone abuse • We examine four domains in predicting the admission of clients for oxycodone abuse/dependence: • Geographical variables • Treatment center type • Organizational/structural characteristics • Service delivery characteristics The University of Georgia

  4. Research Questions • To what extent are oxycodone admissions a function of regional and rural/urban differences? • Are certain types of centers—based on ownership, funding, and profit status—more likely to be treating oxycodone-dependent clients? • Are there associations between structural characteristics and oxycodone admissions? • Are admissions associated with service delivery characteristics (levels of care, availability of medications, 12-step programming)? The University of Georgia

  5. Methods: Panel Longitudinal Data • Publicly-funded centers (N = 362) • National random sample • Centers receive > 50% funding from government block grants/contracts • Privately-funded centers (N = 401) • National random sample • Centers receive < 50% funding from government block grants/contracts • Sources of data • Independent variables via baseline face-to-face interviews • Public center response rate = 80% • Private center response rate = 87% • Dependent variables via telephone follow-up interviews conducted 6 months after baseline • Response rate = 86.9% (N = 666) • Respondents are center administrators/clinical directors The University of Georgia

  6. Methods: Variables & Analysis • Dependent Variable 1: Any Oxycodone Admissions in Past Six Months • 1 = yes, 0 = no • Logistic regression analysis • Dependent Variable 2: Number of Oxycodone Admissions in Past Six Months • Count data • Negative binomial regression analysis • Independent Variables • Geographical Measures: Region, Location in rural county • Center Type: Government-owned, publicly funded non-profit (reference), privately funded non-profit, for-profit • Other Center Characteristics: Center size in FTEs, Center age, Accreditation (JCAHO, CARF), Location in hospital • Service Delivery: Levels of care (inpatient-only, inpatient & outpatient, outpatient-only), Offers buprenorphine, Offers naltrexone, Offers methadone, Requires 12-step meeting attendance during treatment • Controls for year of baseline interview The University of Georgia

  7. Descriptive Statistics: Independent Variables The University of Georgia

  8. Oxycodone Admissions in the Past Six Months • The majority of centers reported at least one admission in the prior six months • The average number of admissions over the previous six-month period was 17.3 admissions (SD = 51.48) The University of Georgia

  9. Logistic Regression (N = 597):Any Oxycodone Admissions in Past Six Months +p<.10, *p<.05, **p<.01, ***p<.001 (two-tailed) The University of Georgia

  10. Negative Binomial Regression (N = 509):Number of Oxycodone Admissions *p<.05, **p<.01, ***p<.001 (two-tailed) The University of Georgia

  11. Key Findings • Geographical Variables • While location in a rural county did not predict “any admissions,” centers in rural counties reported a significantly greater number of admissions • Region was only significant in the “any admissions” model • Center Type • Oxycodone admissions were significantly related to treatment sector • Both for-profit & privately funded non-profits had greater oxycodone admissions than publicly funded non-profits The University of Georgia

  12. Key Findings (Continued) • Organizational/structural characteristics • Center size mattered • JCAHO accreditation was positively associated with the number of admissions • Service Delivery • Admissions are somewhat a function of the availability of pharmacotherapy for opiate addiction • Requiring 12-step meeting attendance was also positively associated with admissions The University of Georgia

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