Studies from Cleveland Clinic Provide New Data on Managed Care (Disparities In Treatment for Alcohol Use Disorder Among All of Us Participants): Managed Care

Health Policy and Law Daily

2024 DEC 06 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- A new study on Managed Care is now available. According to news reporting from Cleveland, Ohio, by NewsRx journalists, research stated, “The authors examined racial/ethnic and socioeconomic disparities in receiving treatment for alcohol use disorder (AUD).
Methods: A retrospective cohort study was conducted that included adults (>= 18 years) with AUD from the All of Us Controlled Tier database v7. Outcomes were lifetime receipt of FDA-approved medications (disulfiram, acamprosate, and naltrexone), psychotherapy (individual, family, and group- based session), and combination treatment (medication and psychotherapy).”

Financial support for this research came from NIH National Institute on Alcohol Abuse & Alcoholism (NIAAA).

The news correspondents obtained a quote from the research from Cleveland Clinic, “The study examined treatment receipt by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, other), insurance (private, Medicare, Medicare and Medicaid, Medicaid, Veteran Affairs [VA], none), income (<$10K, $10- <$50K, $50-$100K, >$100K), and area deprivation index (ADI) quintiles. Multivariable logistic and multinomial logistic regressions were used to assess the association between patient characteristics and treatment receipt. The cohort consisted of 18,692 patients (mean age=57.1 years; 60.7% were male; 47.1% were non-Hispanic White). Almost 70% received no treatment, 11.4% received medication, 24.0% received psychotherapy, and 4.9% received combination treatment. In adjusted analysis, non- Hispanic Black (aOR=0.78, 95%CI=0.69-0.89) and Hispanic (aOR=0.75, 95% CI=0.64-0.88) individuals were less likely to receive medication than non-Hispanic White counterparts. There was no association between race/ethnicity and receipt of psychotherapy or combination treatment. Compared with private insurance, dual eligibility was associated with less use of medication, Medicare and Medicaid with less use of medication and combination treatment, and VA and no insurance with more use of psychotherapy and combination treatment. Higher income and lower ADI were positively associated with all treatment types.
Conclusions: There are disparities in AUD treatment by race/ ethnicity, socioeconomic status, and insurance.”

According to the news reporters, the research concluded: “Systematic approaches are required to improve equitable access to effective treatment.”

This research has been peer-reviewed.

For more information on this research see: Disparities In Treatment for Alcohol Use Disorder Among All of Us Participants. American Journal of Psychiatry, 2024;181(11):973-987. American Journal of Psychiatry can be contacted at: Amer Psychiatric Publishing, Inc, 800 Maine Ave SW, Suite 900, Washington, DC 20024, USA.

Our news journalists report that additional information may be obtained by contacting Phuc Le, Cleveland Clinic, Center for Value-Based Care Research, Cleveland, OH 44106, United States. Additional authors for this research include Jacob James Rich, Hamlet Gasoyan, Michael B. Rothberg, Gina Ayers, Eden Y. Bernstein, Joseph Glass, Sudie E. Back and Thanh C. Bui.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1176/appi.ajp.20230730. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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