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Making the business case for an addiction medicine consult service: a qualitative analysis.

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  • المؤلفون: Priest KC;Priest KC;Priest KC; McCarty D; McCarty D; McCarty D
  • المصدر:
    BMC health services research [BMC Health Serv Res] 2019 Nov 08; Vol. 19 (1), pp. 822. Date of Electronic Publication: 2019 Nov 08.
  • نوع النشر :
    Journal Article; Multicenter Study
  • اللغة:
    English
  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: London : BioMed Central, [2001-
    • الموضوع:
      Addiction Medicine/*organization & administration ; Opioid-Related Disorders/*rehabilitation; Continuity of Patient Care ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Narcotic Antagonists/therapeutic use ; Opiate Substitution Treatment/methods ; Patient Acceptance of Health Care ; Quality of Health Care ; Referral and Consultation ; United States
    • نبذة مختصرة :
      Background: As the drug poisoning crisis worsens in North America and opioid use disorder (OUD)-related hospital admissions increase, policymakers and hospital administrators are beginning to recognize the important role of hospitals in the OUD care continuum. This study explores and describes how U.S. addiction medicine physicians created and presented business propositions to hospital administrators to support the development of addiction medicine consult (AMC) services.
      Methods: Fifteen qualitative interviews were completed with board-certified or board-eligible addiction medicine physicians from 14 U.S. hospitals. The interviews occurred as part of a broader mixed methods study exploring hospital service delivery for patients admitted with OUD. Using a directed content analysis, the transcribed interviews were coded, analyzed, and final themes consolidated.
      Results: Semi-structured interviews completed with addiction medicine physicians from established (n = 9) and developing (n = 5) AMC services at 14 U.S. hospitals explored how clinical champions persuaded hospital administrators to support AMC service development. Four elements were foundational to making the "business case": 1) describing the prevalence of substance use disorder (SUD) or OUD in the hospital; 2) identifying the negative financial impacts of not treating SUDs during hospitalization; 3) highlighting the ongoing care quality and treatment gap for hospitalized patients with SUDs; and 4) noting the success of other institutional AMC services. Study findings informed the creation of tools to support AMC service development: 1) an AMC service business case template, and 2) an AMC service design and operations resource list.
      Conclusions: OUD-related hospital admissions are unlikely to abate. Hospital administrators should consider innovative care delivery mechanisms to improve care for persons with OUD. AMC services may be a promising delivery mechanism to achieve this aim. For clinical and administrative champions, understanding how to communicate the potential effectiveness of this intervention to hospital leaders is an essential first step to AMC service creation.
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    • Grant Information:
      R33 DA035640 United States DA NIDA NIH HHS; F30 DA044700 United States DA NIDA NIH HHS; UG1 DA015815 United States DA NIDA NIH HHS
    • Contributed Indexing:
      Keywords: Addiction consult service; Addiction medicine consult service; Buprenorphine/naloxone; Consultation service; Hospital leadership; Hospital management; Methadone; Opioid agonist therapy; Opioid use disorder; Substance use disorder
    • الرقم المعرف:
      0 (Narcotic Antagonists)
    • الموضوع:
      Date Created: 20191110 Date Completed: 20200210 Latest Revision: 20231019
    • الموضوع:
      20231019
    • الرقم المعرف:
      PMC6842195
    • الرقم المعرف:
      10.1186/s12913-019-4670-4
    • الرقم المعرف:
      31703741