Predictors of Healthcare Effectiveness Data and Information Set (HEDIS) treatment initiation and engagement among patients with opioid use disorder across 7 health systems

Figures & data

Table 1. Characteristics of patients with opioid use disorder by treatment initiation*.

	Initiated treatment		Did not initiate treatment
	(n = 1,331)		(n = 8,510)
Characteristic	n	%	n	%	P value
Sex					<.001
Female	562	42.2	4,662	54.8
Male	769	57.8	3,848	45.2
Age					<.001
18–29	438	33.3	2,527	29.7
30–49	443	23.7	2,930	34.4
50–64	316	32.9	1,189	14.0
65+	134	10.1	1,864	21.9
Race/ethnicity					0.031
American Indian/Alaska Native	14	1.1	136	1.6
Asian	35	2.6	142	1.7
Native Hawaiian/other Pacific Islander	6	0.5	33	0.4
Black/African American	81	6.1	678	8.0
Hispanic	202	15.2	1,257	14.8
White	919	69.1	5,809	68.3
Other/unknown	74	5.6	455	5.4
Psychiatric conditions in prior year	706	56.0	4,797	56.4	.023
Medical conditions in prior year	769	57.8	5,883	69.1	<.001
Index encounter type, %					<.001
Inpatient	n/a	n/a	n/a	n/a
Emergency department	206	15.5	1,102	13.0
Primary care	438	32.9	4,716	55.4
Psychiatry/AOD treatment	556	41.8	1,499	17.6
Other outpatient	131	9.8	1,193	14.0

*Initiation was estimated among patients with an OUD index diagnosis during an encounter in an outpatient or ED setting (i.e., not inpatient) (n = 9,841).

Table 2. Adjusted odds of treatment initiation among patients with an index OUD diagnosis.

Characteristic	OR	95% CI
Sex
Female	0.72	0.62, 0.85
Male (ref)	—	—
Age
18–29 (ref)	—	—
30–49	0.58	0.49, 0.68
50–64	0.42	0.35, 0.51
65+	0.34	0.26, 0.43
Race/ethnicity
American Indian/Alaska Native	0.69	0.38, 1.26
Asian	1.31	0.87, 1.98
Native Hawaiian/other Pacific Islander	0.87	0.34, 2.21
Black/African American	0.92	0.71, 1.20
Hispanic	0.96	0.80, 1.16
White (ref)	—	—
Other/unknown	0.77	0.57, 1.04
Psychiatric conditions in prior year	1.07	0.91, 1.26
Medical conditions in prior year	0.97	0.82, 1.14
Index encounter type, %
Inpatient	n/a	n/a
Emergency department	1.58	1.27, 1.97
Psychiatry/AOD treatment	2.92	2.47, 3.46
Other outpatient	1.14	0.91, 1.43
Primary care (ref)	—	—

Table 3. Patient characteristics by treatment engagement among patients with an opioid use disorder who initiated*.

	Engaged in treatment		Did not engage in treatment
	(n = 561)		(n = 2,402)
Characteristic	n	%	n	%	P value
Sex					<.001
Female	230	41.0	1,317	54.8
Male	331	59.0	1,085	45.2
Age					<.001
18–29	202	36.0	373	15.5
30–49	211	37.6	543	22.6
50–64	114	20.3	811	33.8
65+	34	6.1	675	28.1
Race/ethnicity					<.001
American Indian/Alaska Native	7	1.3	34	1.4
Asian	15	2.7	49	2.0
Native Hawaiian/other Pacific Islander	3	0.5	5	0.2
Black/African American	24	4.3	231	9.6
Hispanic	100	17.8	315	13.1
White	378	67.4	1,666	69.4
Other/unknown	34	6.1	102	4.3
Psychiatric conditions in prior year	291	51.9	1,600	66.6	.123
Medical conditions in prior year	295	52.6	1,990	82.9	<.001
Index encounter type, %					<.001
Inpatient	74	13.2	1,558	64.9
Emergency department	55	9.8	151	6.3
Primary care	111	19.8	327	13.6
Psychiatry/AOD treatment	289	51.5	267	11.1
Other outpatient	32	5.7	99	4.1

* Engagement was estimated among all patients with an OUD index diagnosis who initiated AOD treatment, including patients with an index inpatient encounter (n = 2,963).

Table 4. Adjusted odds of treatment engagement among patients who initiated treatment*.

Characteristic	OR	95% CI
Sex
Female	0.95	0.72, 1.26
Male (ref)	—	—
Age
18–29 (ref)	—	—
30–49	1.02	0.77, 1.35
50–64	0.64	0.46, 0.88
65+	0.36	0.22, 0.57
Race/ethnicity
American Indian/Alaska Native	1.30	0.50, 3.37
Asian	0.87	0.43, 1.77
Native Hawaiian/other Pacific Islander	1.45	0.27, 7.83
Black/African American	0.61	0.37, 1.01
Hispanic	1.17	0.86, 1.58
White (ref)	—	—
Other/unknown	1.20	0.74, 1.95
Psychiatric conditions in prior year	1.03	0.77, 1.38
Medical conditions in prior year	0.70	0.52, 0.95
Index encounter type, %
Inpatient	0.19	0.14, 0.27
Emergency department	0.99	0.66, 1.50
Psychiatry/AOD treatment	2.67	1.98, 3.60
Other outpatient	0.93	0.57, 1.52
Primary care (ref)	—	—

* Engagement was estimated among all patients with an OUD index diagnosis who initiated AOD treatment, including patients with an index inpatient encounter (n = 2,963).