Table 3.
Article | Measure | Setting | Data source | Sample size | Primary outcome | Results | Specific to OUD? |
---|---|---|---|---|---|---|---|
Harris & Bowe, 2008 | HEDIS Initiation and Engagement | VHA | Administrative data | N = 270,877 patients | Rates of initiation and engagement | Overall initiation and engagement rates of 29.6% and 30.1%. Patients who were female, not married, younger, and had their SUDs identified in a SUD or psychiatric specialty settings had higher rates. Engagement rates higher when treatment initiation was in outpatient settings. | No |
Harris, Bowe, Finney, & Humphreys, 2009 | HEDIS Initiation and Engagement | VHA | Administrative data | N = 320,238 patients | Rates of initiation and engagement | Patients diagnosed with SUD in specialty settings more likely to progress to Initiation and Engagement but a significant amount of AOD care occurs outside of specialty settings in a given system, i.e. 25% of initiation and over 40% of engagement | No |
Brown, Bennett, Li, & Bellack, 2011 | HEDIS initiation and engagement | Randomized sample of treatment-seeking patients with comorbid SMI and SUD | Multisite RCT data | N = 175 patients | Rates of initiation and engagement | Among patients with serious mental illness, males (AOR 0.46) and those with schizophrenia (AOR 0.44) had lower initiation rates. Those with current (v. recent) drug dependence (AOR 0.30) or a recent arrest (AOR 0.37) were less likely to engage | No |
Lee, Garnick, O’Brien, et al., 2012 | HEDIS initiation and engagement | Outpatient multisite pilot study across 12 states; adolescents | Secondary data, 28 outpatient clinics | N = 2191 patients | Rates of initiation and engagement among adolescents | 76% of the sample Initiated, with 59% Engaged. Mixed race and highly truant adolescents had lower initiation rates. Latino youth were less likely to engage. | No |
Acevedo, Garnick, Dunigan, et al., 2015 | HEDIS initiation and engagement | Public sector AOD treatment centers in 4 states | Administrative linked with criminal justice data | N = 108,654 patients | Rates of engagement with emphasis on racial disparities | Racial minorities often had lower initiation and engagement rates but there was great variation and mixed findings across the four states | No |
Bensley, Harris, Gupta, et al., 2017 | HEDIS initiation and engagement | Patients with alcohol use disorder in the VHA | Administrative data | N = 90,879 patients | Rates of initiation and engagement | Engagement results varied with measure specification but were more likely for black patients (AOR 1.1) relative to white patients | No |
Watkins, Ober, Lamp, et al., 2017 | HEDIS initiation and engagement | Collaborative Care intervention model in a FQHC | RCT data including EHR and pharmacy logs | N = 377 patients | Rates of initiation and engagement | Higher rates among collaborative care participants versus TAU: Initiation 31.6% vs 13.7% (AOR 3.54); Engagement, 15.5% vs 4.2% (AOR 5.89) | No |
VHA = Veterans Health Administration; AOD = Alcohol or other drug; SMI = serious mental illness; RCT = randomized controlled trial; TAU = Treatment as usual; AOR = Adjusted odds ratio; Federally Qualified Health Center; EHR = Electronic Health Records.