28 Feb More Hospitals Dropped Addiction Services Than Added Them
MedicalResearch.com Interview with:
Cory E. Cronin PhD
Department of Social and Public Health
Ohio University College of Health Sciences and Professions
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: One of my primary areas of research is exploring how hospitals interact with their local communities. My own background is in health administration and sociology, and I have been working with colleagues in the Heritage College of Osteopathic Medicine here at Ohio University (Berkeley Franz, Dan Skinner and Zelalem Haile) to conduct a series of studies looking at questions related to these hospital-community interactions.
This particular question occurred to us because of the timeliness of the opioid epidemic. In analyzing data collected from the American Hospital Association and other sources, we identified that the number of hospitals offering in-patient and out-patient substance use disorder services actually dropped in recent years, in spite of the rising number of overdoses due to opioid use. Other factors seemed to matter more in regard to whether a hospital offered these services or not.
MedicalResearch.com: How many hospitals have made this decision?
Response: The study analyzed data for 3,365 acute-care hospitals across the country, from the 2010 and 2015 installments of the American Hospital Association Annual Survey. In the time between the two surveys, our findings showed a net loss of in-patient and out-patient opioid-related programs, even as overdose deaths continued to climb, among the hospitals that responded to both surveys. While some hospitals added programs during this period, a greater number discontinued them. In 2010, a total of 334 hospitals surveyed offered in-patient services and 588 offered out-patient services, but by 2015 these numbers had dropped to 327 and 577, respectively.
MedicalResearch.com: What should readers take away from your report?
Response: I think a key takeaway to our findings is that not all hospitals approach community health issues in the same way or feel able to respond to what we might view as an clear need. We found that hospitals that employed medical home models and hospitals that might consider themselves to be safety nets were more likely to provide services to address substance use disorders. On the other hand, hospitals that share a county with a psychiatric facility are less likely to provide services, leading us to theorize that hospitals may defer these responsibilities to other facilities they see as more specialized, if those facilities are present in a community.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: These findings are all based on secondary, quantitative data, and there are plenty of questions that weren’t included in that data. An approach that focuses on talking to hospitals directly regarding their motivations, limitations, resources, and initiatives would be valuable in broadening the understanding of what hospitals perceive their role to be in addressing community health issues generally and the opioid epidemic specifically.
Hospitals and substance use disorder services in the time of the opioid epidemic
Cory E. Cronin PhD, Berkeley Franz PhD, Daniel Skinner PhD, Zelalem T. Haile PhD, MPH
First published: 05 February 2019
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