title: Disparities in access to physicians and medications for the treatment of substance use disorders between publicly and privately funded treatment programs in the United States.
abstract: OBJECTIVE
  Prior research suggests that publicly funded substance use disorder (SUD) treatment programs lag behind privately funded programs in adoption of evidence-based practices, resulting in disparities in access to high-quality SUD treatment. These disparities highlight a critical public health concern because the majority of SUD patients in the United States are treated in the publicly funded treatment sector. This study uses recent data to examine disparities in access to physicians and availability of medications for the treatment of SUDs between publicly and privately funded SUD treatment programs.
  
  
  METHODS
  Data were collected from 595 specialty SUD treatment programs from 2007 to 2010 via face-to-face interviews, mailed surveys, and telephone interviews with treatment program administrators.
  
  
  RESULTS
  Publicly funded programs were less likely than privately funded programs to have a physician on staff, even after controlling for several organizational characteristics that were associated with access to physicians. The results of negative binomial regression indicated that, even after taking into account physician access and other organizational variables, publicly funded programs prescribed fewer SUD medications than privately funded SUD treatment programs.
  
  
  CONCLUSIONS
  Patients seeking treatment in publicly funded treatment programs continue to face disparities in access to high-quality SUD treatment that supports patients' choices among a range of medication options. However, implementation of the Affordable Care Act may facilitate greater access to physicians and use of medications in publicly funded SUD treatment programs.
authors: Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina 29208, USA. aabraham@mailbox.sc.edu
authors: Amanda J
authors: AJ
authors: Abraham
authors: Hannah K
authors: HK
authors: Knudsen
authors: Traci
authors: T
authors: Rieckmann
authors: Paul M
authors: PM
authors: Roman
mesh_terms: D055317:Evidence-Based Practice / Q000191:economics; D005380:Financing, Government / Q000191:economics; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics*; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D010820:Physicians / Q000191:economics / Q000600:supply & distribution; D017149:Private Sector / Q000191:economics; D012044:Regression Analysis; D016320:Substance Abuse Treatment Centers / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D014481:United States
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