Facility Attractiveness and Social Vulnerability Impacts on Spatial Accessibility to Opioid Treatment Programs in South Carolina.

Parisa Bozorgi,Jan M Eberth,Jeannie P Eidson,Dwayne E Porter

doi:10.3390/ijerph18084246

Abstract

Opioid dependence and opioid-related mortality have been increasing in recent years in the United States. Available and accessible treatments may result in a reduction of opioid-related mortality. This work describes the geographic variation of spatial accessibility to opioid treatment programs (OTPs) and identifies areas with poor access to care in South Carolina. The study develops a new index of access that builds on the two-step floating catchment area (2SFCA) method, and has three dimensions: a facility attractiveness index, defined by services rendered incorporated into the Huff Model; a facility catchment area, defined as a function of facility attractiveness to account for variable catchment size; and a Social Vulnerability Index (SVI) to account for nonspatial factors that mitigate or compound the impacts of spatial access to care. Results of the study indicate a significant variation in access to OTPs statewide. Spatial access to OTPs is low across the entire state except for in a limited number of metropolitan areas. The majority of the population with low access (85%) live in areas with a moderate-to-high levels of social vulnerability. This research provides more realistic estimates of access to care and aims to assist policymakers in better targeting disadvantaged areas for OTP program expansion and resource allocation.

Highlights

We evaluated the relation between our model (i.e., the weighted 2SFCA (W2SFCA)) and the 2SFCA model using the Spearman correlation coefficient and the intraclass correlation coefficient (ICC)
We developed a composite index of attractiveness based on factors including the type of opioid treatment provided, availability of counseling services, provision of detoxification, ancillary services provided, payment/insurance types accepted, and language services available
This study provides a new perspective for analyzing health-care accessibility, including both spatial and nonspatial factors to define the accessibility of opioid treatment programs (OTPs) in South Carolina

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. In the United States, drug-overdose deaths have more than tripled from 1999 to 2018. In 2018, opioid overdose was involved in almost 70% of these deaths [1]. In 2019, a total of 1131 drug-overdose deaths occurred in South Carolina, a 2.5% increase from 2018 with

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