Table 3. Days to First Appointment for Methadone by Clinic Open Access Model or COVID-19 Adaptation Among US and Canadian Methadone Clinics in 2020.
| Variable | Days to first appointment | ||||
|---|---|---|---|---|---|
| No. | Yes, mean (95% CI) | No. | Yes, mean (95% CI) | P value | |
| Open access modela | |||||
| US Medicaidb | 57 | 1.9 (1.5-2.4) | 133 | 4.2 (3.3-5.1) | <.001 |
| US self-pay | 57 | 2.5 (1.9-3.0) | 136 | 4.8 (3.8-5.7) | <.001 |
| Canadian | 115 | 1.6 (1.3-1.8) | 80 | 2.3 (1.9-2.8) | .003 |
| Telemedicine prescribingc | |||||
| US Medicaid | 73 | 3.4 (2.5-4.4) | 77 | 3.3 (2.5-4.2) | .89 |
| Canadian | 59 | 2.1 (1.6-2.6) | 54 | 1.7 (1.3-2.1) | .23 |
| Increased take-home medicationsd | |||||
| US Medicaid | 52 | 2.6 (1.9-3.3) | 100 | 3.8 (2.9-4.7) | .04 |
| Increased take-home medications by clinic open access status | |||||
| US Medicaid with open access | 14 | 2.0 (1.0-3.0) | 31 | 1.7 (1.2-2.3) | .62 |
| US Medicaid without open access | 38 | 2.8 (1.9-3.7) | 69 | 4.7 (3.5-5.9) | .01 |
| Bottle drop-off serviced | |||||
| US Medicaid | 17 | 3.7 (1.4-6.0) | 133 | 3.3 (2.7-4.0) | .72 |
a
Weekly walk-in hours for new patients without appointment.
b
Standardized patient calls were made simulating a patient aged 30 years seeking to start methadone treatment. Within the US, clinics were contacted twice: once as a patient with Medicaid and once as a patient with no health insurance (self-pay). Within Canada, clinics were contacted once as a patient with provincial insurance.
c
To reduce question burden, US clinics were not asked about COVID-19 adaptations during self-pay calls.
d
Adaptations (take-home medication and bottle drop-off service among Canadian clinics were too infrequent for comparison).