Racial/ethnic disparities in the availability of hospital based opioid use disorder treatment

Ji Eun Chang; Berkeley Franz; Cory E Cronin; Zoe Lindenfeld; Alden Yuanhong Lai; José A Pagán

doi:10.1016/j.jsat.2022.108719

Racial/ethnic disparities in the availability of hospital based opioid use disorder treatment

J Subst Abuse Treat. 2022 Jul:138:108719. doi: 10.1016/j.jsat.2022.108719. Epub 2022 Feb 1.

Authors

Ji Eun Chang¹, Berkeley Franz², Cory E Cronin³, Zoe Lindenfeld⁴, Alden Yuanhong Lai⁵, José A Pagán⁶

Affiliations

¹ Department of Public Health Policy and Management, School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA. Electronic address: ji.chang@nyu.edu.
² Heritage College of Osteopathic Medicine, Ohio University, 1 Ohio University, Athens, OH 45701, USA. Electronic address: franzb@ohio.edu.
³ College of Health Sciences and Professions, Ohio University, 1 Ohio University, Athens, OH 45701, USA. Electronic address: croninc@ohio.edu.
⁴ Department of Public Health Policy and Management, School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA. Electronic address: zll213@nyu.edu.
⁵ Department of Public Health Policy and Management, School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA. Electronic address: aldenlai@nyu.edu.
⁶ Department of Public Health Policy and Management, School of Global Public Health, New York University, 708 Broadway, New York, NY 10003, USA. Electronic address: jose.pagan@nyu.edu.

PMID: 35125254
DOI: 10.1016/j.jsat.2022.108719

Abstract

Introduction: While racial/ethnic disparities in the use of opioid use disorder (OUD) treatment in outpatient settings are well documented in the literature, little is known about racial/ethnic disparities in access to hospital-based OUD services. This study examines the relationship between hospital-based or initiated OUD services and the racial/ethnic composition of the surrounding community.

Methods: We constructed a dataset marking the implementation of eight OUD strategies for a 20% random sample of nonprofit hospitals in the United States based on 2015-2018 community health needs assessments. We tested the significance of the relationship between each OUD strategy and the racial/ethnic composition of the surrounding county using two-level mixed effects logistic regression models that considered the hierarchical structure of the data of hospitals within states while controlling for hospital-level county-level, and state-level covariates.

Results: In both unadjusted and adjusted models, we found that hospital adoption of several OUD services significantly varied based on the percentage of Black or Hispanic residents in their communities. Even after controlling for hospital size, the overdose burden in the community, community socioeconomic characteristics, and state funding, hospitals in communities with high percentage of Black or Hispanic residents had significantly lower odds of offering the most common hospital-based programs to address OUD - including programs that increase access to formal treatment services, prescriber guidelines, targeted risk education and harm reduction, and community coalitions to address opioid use.

Conclusions: Hospital adoption of many OUD services varies based on the percentage of Black or Hispanic residents in their communities. More attention should be paid to the role, ability, and strategies that hospitals can assume to address disparities among OUD treatment and access needs, especially those that serve communities with a high concentration of Black and Hispanic residents.

Keywords: Healthcare disparities; Hospitals; Opioid-related disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Ethnicity*
Hispanic or Latino
Hospitals
Humans
Opioid-Related Disorders* / drug therapy
Racial Groups
United States