792: Optimizing care for mothers and newborns affected by opioids by understanding disparities in treatment

Abstract

The Illinois Perinatal Quality Collaborative (ILPQC) Mothers and Newborns affected by Opioids Obstetric quality improvement (QI) initiative aims to increase the percent of women with Opioid Use Disorder (OUD) linked to Medication Assisted Treatment (MAT) and behavioral health /recovery services. The objective of this analysis is to assess the association between patient demographics and receipt of recommended treatment for women with OUD at participating hospitals during the first year of the initiative to inform QI strategies and improve equity. 89 participating hospitals recorded monthly data in the ILPQC Data System for 886 women with OUD who delivered in the first year of the initiative starting May 2018. ILPQC facilitated collaborative learning opportunities, rapid-response data, and quality improvement support for hospital teams. Differences in demographics were assessed for women receiving recommended care for OUD (including linkage to MAT, behavioral health / recovery services, and Narcan counselling by delivery discharge) using logistic regression analysis. Hospital teams have shown improvement across all initiative aims, however gaps in care remain. Compared to all women with OUD reported in the first year of the initiative, women with Black or Hispanic race/ethnicity, age < 25, no prenatal care or care in a rural location were less likely to be linked to MAT and recovery services (Tab). Rates of women receiving MAT also differed by hospital of delivery (Fig). No demographic differences were seen for Narcan counseling, however counseling rates overall were low. Linkage to MAT/behavioral health counseling/recovery services and receipt of Narcan counselling for pregnant women with OUD reduces maternal overdose deaths and improves pregnancy outcomes. However, receipt of recommended treatment for OUD differs by demographic characteristics including race/ethnicity, age and location of care. Improved understanding of these disparities can help reduce bias, improve equity and optimize care for all pregnant and postpartum women with OUD.View Large Image Figure ViewerDownload Hi-res image Download (PPT)