Subtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United States
Abstract Background Opioid use disorder often co-occurs with other mental health and substance use disorders. Identifying clusters of individuals receiving treatment for opioid use disorder based on co-diagnosed conditions, healthcare plans, and service utilization over a seven-year treatment period...
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BMC
2025-05-01
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| Series: | Addiction Science & Clinical Practice |
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| Online Access: | https://doi.org/10.1186/s13722-025-00564-z |
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| author | Orrin D. Ware Jamey J. Lister Sarah E. Cooper Andrew H. Kim Holly H. Lister N. Andrew Peterson Stephen Fioravanti Kristen Gilmore Powell Stephanie C. Marcello Bethany Joseph |
| author_facet | Orrin D. Ware Jamey J. Lister Sarah E. Cooper Andrew H. Kim Holly H. Lister N. Andrew Peterson Stephen Fioravanti Kristen Gilmore Powell Stephanie C. Marcello Bethany Joseph |
| author_sort | Orrin D. Ware |
| collection | DOAJ |
| description | Abstract Background Opioid use disorder often co-occurs with other mental health and substance use disorders. Identifying clusters of individuals receiving treatment for opioid use disorder based on co-diagnosed conditions, healthcare plans, and service utilization over a seven-year treatment period provides insight into service needs. Objectives included [1] characterizing the sample [2], examining subtypes of the sample using cluster analysis, and [3] identifying differences in Current Procedural Terminology by subtype to examine service utilization among identified clusters. Methods This study uses secondary data from the electronic medical records of a community health center in a large urban area in the Northeastern United States from 2015 to 2021. The study sample included N = 705 adults who had an opioid use disorder diagnosis as indicated by the community health center’s electronic medical records. Measures include [1] age [2], race and ethnicity [3], sex [4], healthcare plan(s) [5], co-occurring mental health disorder [6], co-occurring substance use disorder [7], co-occurring mental health disorder or substance use disorder, and [8] Current Procedural Terminology codes for behavioral health service utilization. Cluster analysis was used to examine the sample. These clusters were then analyzed for service utilization with a one-way analysis of variance. Results The cluster analysis identified six clusters with an average silhouette of 0.5, indicating good clustering. These six clusters were operationalized as [1] Medicare/Medicaid healthcare plan with substance use disorder needs [2], Private pay and charity care healthcare plan with cocaine use disorder needs [3], Medicare/Medicaid and other publicly-funded healthcare plans with mood disorder needs [4], Private healthcare plan with low co-occurring disorder needs [5], Other publicly-funded healthcare plan with cannabis use disorder needs [6], Medicare/Medicaid healthcare plan with mental health disorder needs. Service utilization differed between these clusters with cluster mean differences for psychotherapy sessions (F = 8.55, p < 0.001), psychiatric sessions (F = 22.72, p < 0.001), and group therapy sessions (F = 10.76, p < 0.001). Conclusions This study highlights the importance of comprehensive and integrated treatment for substance use disorders and mental health disorders, particularly for those in underserved communities. Healthcare coverage, a socioeconomic factor that impacts access to care, is critical in distinguishing treatment needs and utilization. |
| format | Article |
| id | doaj-art-0f0bef8320864e23a106cd121db63774 |
| institution | OA Journals |
| issn | 1940-0640 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Addiction Science & Clinical Practice |
| spelling | doaj-art-0f0bef8320864e23a106cd121db637742025-08-20T02:15:05ZengBMCAddiction Science & Clinical Practice1940-06402025-05-0120111010.1186/s13722-025-00564-zSubtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United StatesOrrin D. Ware0Jamey J. Lister1Sarah E. Cooper2Andrew H. Kim3Holly H. Lister4N. Andrew Peterson5Stephen Fioravanti6Kristen Gilmore Powell7Stephanie C. Marcello8Bethany Joseph9School of Social Work, University of North Carolina at Chapel HillSchool of Social Work, Rutgers, The State University of New JerseySchool of Social Work, Rutgers, The State University of New JerseySchool of Social Work, Rutgers, The State University of New JerseyCenter for Integrated Care, University Behavioral Health Care, Rutgers HealthSchool of Social Work, Rutgers, The State University of New JerseyTrinitas Regional Medical Center, Robert Wood Johnson Barnabas HealthSchool of Social Work, Rutgers, The State University of New JerseyCenter for Integrated Care, University Behavioral Health Care, Rutgers HealthTrinitas Regional Medical Center, Robert Wood Johnson Barnabas HealthAbstract Background Opioid use disorder often co-occurs with other mental health and substance use disorders. Identifying clusters of individuals receiving treatment for opioid use disorder based on co-diagnosed conditions, healthcare plans, and service utilization over a seven-year treatment period provides insight into service needs. Objectives included [1] characterizing the sample [2], examining subtypes of the sample using cluster analysis, and [3] identifying differences in Current Procedural Terminology by subtype to examine service utilization among identified clusters. Methods This study uses secondary data from the electronic medical records of a community health center in a large urban area in the Northeastern United States from 2015 to 2021. The study sample included N = 705 adults who had an opioid use disorder diagnosis as indicated by the community health center’s electronic medical records. Measures include [1] age [2], race and ethnicity [3], sex [4], healthcare plan(s) [5], co-occurring mental health disorder [6], co-occurring substance use disorder [7], co-occurring mental health disorder or substance use disorder, and [8] Current Procedural Terminology codes for behavioral health service utilization. Cluster analysis was used to examine the sample. These clusters were then analyzed for service utilization with a one-way analysis of variance. Results The cluster analysis identified six clusters with an average silhouette of 0.5, indicating good clustering. These six clusters were operationalized as [1] Medicare/Medicaid healthcare plan with substance use disorder needs [2], Private pay and charity care healthcare plan with cocaine use disorder needs [3], Medicare/Medicaid and other publicly-funded healthcare plans with mood disorder needs [4], Private healthcare plan with low co-occurring disorder needs [5], Other publicly-funded healthcare plan with cannabis use disorder needs [6], Medicare/Medicaid healthcare plan with mental health disorder needs. Service utilization differed between these clusters with cluster mean differences for psychotherapy sessions (F = 8.55, p < 0.001), psychiatric sessions (F = 22.72, p < 0.001), and group therapy sessions (F = 10.76, p < 0.001). Conclusions This study highlights the importance of comprehensive and integrated treatment for substance use disorders and mental health disorders, particularly for those in underserved communities. Healthcare coverage, a socioeconomic factor that impacts access to care, is critical in distinguishing treatment needs and utilization.https://doi.org/10.1186/s13722-025-00564-zCo-OccurringBehavioral healthDual diagnosisHealthcare coverageOpioid use disorderService |
| spellingShingle | Orrin D. Ware Jamey J. Lister Sarah E. Cooper Andrew H. Kim Holly H. Lister N. Andrew Peterson Stephen Fioravanti Kristen Gilmore Powell Stephanie C. Marcello Bethany Joseph Subtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United States Addiction Science & Clinical Practice Co-Occurring Behavioral health Dual diagnosis Healthcare coverage Opioid use disorder Service |
| title | Subtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United States |
| title_full | Subtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United States |
| title_fullStr | Subtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United States |
| title_full_unstemmed | Subtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United States |
| title_short | Subtypes and service utilization among opioid use disorder patients at a community health center: findings from a medically underserved urban area of the Northeastern United States |
| title_sort | subtypes and service utilization among opioid use disorder patients at a community health center findings from a medically underserved urban area of the northeastern united states |
| topic | Co-Occurring Behavioral health Dual diagnosis Healthcare coverage Opioid use disorder Service |
| url | https://doi.org/10.1186/s13722-025-00564-z |
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