Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care.

Katherine J Hoggatt,Donna L Washington,Fay S Saechao,Susan M Frayne,Elizabeth M Yano

doi:10.1089/heq.2018.0069

Abstract

Purpose: To assess disparities in primary care experiences for patients with a substance use disorder (SUD) diagnosis.Methods: We assessed differences in Veterans Health Administration (VA) primary care patients' experiences using data from the 2014 outpatient VA Patient-Centered Medical Home Survey of Healthcare Experiences of Patients (SHEP; N=286,026). We obtained patient demographics and diagnoses from VA electronic medical record data.Results: Patients with an SUD diagnosis reported worse experiences for 8 of 12 SHEP measures, including access, provider communication, and information received (p<0.05).Conclusion: Targeted strategies may be needed to ensure patients with SUD have favorable primary care experiences.

Highlights

Substance use disorder (SUD; abuse or dependence of alcohol or other substances1) is a common and costly health condition
Disparities in preventive care quality have been documented for patients with SUD,[5,6,7,8,9] but the forces contributing to these disparities are still being explored
We obtained patient experience measures covering domains from the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey, which capture experiences relevant to Patient-Centered Medical Home (PCMH).[15]

Summary

Introduction

Substance use disorder (SUD; abuse or dependence of alcohol or other substances1) is a common and costly health condition. 1 in 3 Americans meet criteria for an alcohol use disorder in their lifetime,[2] with 1 in 10 meeting criteria for a drug use disorder,[3] and the consequences of substance misuse and SUD cost the U.S economy >$400 billion annually.[4] Patients with. SUD face negative health consequences related to substance misuse, which may be exacerbated when they are not receiving preventive health care. SUD may face substance-use-related stigma or other barriers to engaging with primary care,[10] which can contribute to disparities in preventive care. The broader health equity literature has cited patient–

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Conclusion