title: Primary care affiliations of adults in a methadone program with onsite care.
abstract: Methadone maintenance treatment programs (MMTP) often provide onsite primary care. It is unclear whether patients in these settings consider the MMTP their usual source of care. We conducted cross-sectional interviews of 62 adults in an inner-city MMTP with onsite primary care to determine their usual source of care. Program enrollment ranged from 1 to 27 years (median, 4) and 63% attended > or = 5 days per week. Seventy-six percent had > or = 1 chronic disease. Only 53% reported having a usual source of care, which included hospital-based clinics (45%), the MMTP (23%), private physicians (19%), other sites (13%). Patients were more likely to identify the MMTP as their usual source of care if they had cardiovascular disease (RR 6.9, 95% CI 2.2 to 21.9) or HIV (RR 5.6, 95% CI 1.7 to 18.5). Successfully promoting appropriate utilization of onsite primary care may require a better understanding of MMTP patients' perceptions of primary care.
authors: Division of General Internal Medicine, Mount Sinai Hospital, New York, NY 10029, USA. alex.federman@mssm.edu
authors: Alex D
authors: AD
authors: Federman
authors: Julia H
authors: JH
authors: Arnsten
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy; D004334:Drug Administration Schedule; D015658:HIV Infections / Q000453:epidemiology; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010349:Patient Compliance / Q000706:statistics & numerical data; D015995:Prevalence; D011314:Preventive Health Services / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods*; D016730:Program Development; D012648:Self Care / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D009294:Narcotics; D008691:Methadone