Patient characteristics associated with treatment initiation and engagement among individuals diagnosed with alcohol and other drug use disorders in emergency department and primary care settings

Figures & data

Table 1. Patient characteristics associated with an alcohol or drug use disorder diagnosis index encounter in October 1, 2014, to August 15, 2015, across 7 health systems by index encounter setting (n = 54,321).

	Setting
	Emergency department (n = 22,553)		Primary care (n = 31,768)
Characteristic	n	%	n	%	P value
Sex, %					<.001
Women	9,493	42.1	11,503	36.2
Men	13,060	57.9	20,265	63.8
Age, %					<.001
18–29	8,019	35.6	4,996	15.7
30–49	6,665	29.6	9,410	29.6
50–64	5,207	23.1	10,256	32.3
65+	2,662	11.8	7,106	22.4
Race/ethnicity, %					<.001
American Indian/Alaska Native	270	1.2	468	1.5
Asian	1,078	4.8	979	3.1
Native Hawaiian/other Pacific Islander	183	0.8	172	0.5
Black/African American	2,596	11.5	2,761	8.7
Hispanic	4,590	20.4	6,788	21.4
White	12,404	55.0	19,161	60.3
Other/unknown	1,432	6.4	1,439	4.5
Insurance type, %					<.001
Commercial/private pay	15,497	68.7	18,609	58.8
Medicare	3,945	17.5	7,807	24.6
State subsidized	2,952	13.1	2,796	8.8
Unknown	159	0.7	2,556	8.1
Type of index diagnosis, %					<.001
Alcohol	12,582	55.8	17,491	55.1
Marijuana	3,805	16.9	4,002	12.6
Opioids	1,308	5.8	5,154	16.2
Other drug	4,858	21.5	5,121	16.1
	Mean	SD	Mean	SD
Charlson-Deyo comorbidity index score	0.73	1.52	0.75	1.45	.2834

Note. SD = standard deviation.

Table 2. Patient characteristics associated with treatment initiation and engagement* among all patients identified with an alcohol or other drug use disorder in an emergency department or primary care setting.

	Treatment initiation (n = 54,321)				Treatment engagement (n = 5,061)
Characteristic	aOR	95% CI		P value	aOR	95% CI			P value
Setting
Emergency department	1.89	1.73	2.07	<.001	0.81		0.65	1.01	.050
Primary care (ref)	—	—		—	—		—		—
Sex
Women	0.87	0.80	0.94	.004	1.09		0.89	1.32	.340
Men (ref)	—	—	—	—	—		—	—	—
Age
18–29 (ref)	—	—	—	—	—		—	—	—
30–49	1.13	1.03	1.23	.011	1.13		0.90	1.42	.260
50–64	1.08	0.98	1.18	.113	0.86		0.67	1.09	.203
65+	0.82	0.73	0.92	.002	0.52		0.37	0.72	.001
Race/ethnicity
American Indian/Alaska Native	0.95	0.73	1.23	.664	1.31		0.70	2.45	.381
Asian	0.73	0.62	0.87	<.001	0.72		0.45	1.15	.163
Native Hawaiian/other Pacific Islander	0.73	0.50	1.09	.118	0.45		0.13	1.61	.212
Black/African American	0.76	0.68	0.85	<.001	0.57		0.40	0.80	.003
Hispanic	0.75	0.69	0.89	<.001	0.83		0.66	1.03	.091
Other/unknown	0.77	0.67	0.89	<.001	0.89		0.64	1.25	.505
White (ref)	—	—	—	—	—		—	—	—
Charlson-Deyo comorbidity index score	1.04	1.01	1.06	<.001	0.89		0.83	0.95	<.001
Type of index diagnosis
Alcohol (ref)	—	—	—	—	—		—	—	—
Marijuana	0.54	0.49	0.61	<.001	0.46		0.32	0.68	<.001
Opioids	1.19	1.08	1.32	<.001	1.46		1.16	1.84	.003
Other drug	1.09	1.00	1.18	.045	0.71		0.57	0.89	.005

Note. aOR = adjusted odds ratio; CI = confidence interval.

*Engagement was estimated among all patients who initiated AOD treatment.

Table 3. Patient characteristics associated with treatment initiation by alcohol or drug abuse/dependence diagnosis index encounter setting.

	Treatment initiation emergency department index encounters (n = 22,553)				Treatment initiation primary care index encounters (n = 31,768)
Characteristic	aOR	95% CI		P value	aOR	95% CI		P value
Sex
Women	0.80	0.72	0.88	<.001	0.97	0.86	1.09	.516
Men (ref)	—	—		—	—	—		—
Age
18–29 (ref)	—	—	—	—	—	—	—	—
30–49	1.25	1.12	1.40	<.001	0.81	0.71	0.94	.007
50–64	1.42	1.26	1.60	<.001	0.68	0.58	0.78	<.001
65+	1.27	1.08	1.49	.006	0.47	0.40	0.56	<.001
Race/ethnicity
American Indian/Alaska Native	0.92	0.63	1.35	.674	0.94	0.65	1.36	.722
Asian	0.74	0.59	0.91	.007	0.79	0.60	1.04	.088
Native Hawaiian/other Pacific Islander	0.66	0.39	1.10	.109	0.86	0.48	1.55	.599
Black/African American	0.70	0.60	0.81	<.001	0.85	0.71	1.02	.075
Hispanic	0.69	0.61	0.78	<.001	0.84	0.74	0.95	.007
Other/unknown	0.63	0.52	0.77	<.001	1.03	0.84	1.26	.769
White (ref)	—	—	—	—	—	—	—	—
Charlson-Deyo comorbidity index score	1.02	1.00	1.05	.110	1.04	1.01	1.08	.012
Type of index diagnosis
Alcohol (ref)	—	—	—	—	—	—	—	—
Marijuana	0.69	0.60	0.80	<.001	0.34	0.33	0.43	<.001
Opioids	1.31	1.10	1.56	.004	1.14	1.00	1.29	.046
Other drug	1.20	1.08	1.33	.002	0.90	0.79	1.03	.126

Note. aOR = adjusted odds ratio; CI = confidence interval.

Table 4. Patient characteristics associated with treatment engagement* by alcohol or drug abuse/dependence diagnosis index encounter setting.

	Treatment engagement emergency department index encounters (n = 2,749)				Treatment engagement primary care index encounters (n = 2,312)
Characteristic	aOR	95% CI		P value	aOR	95% CI		P value
Sex
Women	1.10	0.84	1.44	.428	1.09	0.82	1.43	.494
Men (ref)	—	—		—	—	—		—
Age
18–29 (ref)	—	—	—	—	—	—	—	—
30–49	1.30	0.96	1.76	.081	0.94	0.67	1.32	.726
50–64	0.87	0.62	1.22	.388	0.80	0.56	1.14	.194
65+	0.61	0.38	0.98	.043	0.42	0.26	0.68	.001
Race/ethnicity
American Indian/Alaska Native	1.78	0.75	4.19	.180	1.00	0.40	2.47	.994
Asian	0.63	0.33	1.21	.158	0.84	0.41	1.71	.622
Native Hawaiian/other Pacific Islander	0.67	0.14	3.24	.603	0.27	0.03	2.34	.225
Black/African American	0.53	0.32	0.87	.013	0.60	0.36	0.99	.046
Hispanic	0.82	0.60	1.12	.207	0.80	0.59	1.10	.164
Other/unknown	1.00	0.63	1.60	.998	0.91	0.57	1.45	.677
White (ref)	—	—	—	—	—	—	—	—
Charlson-Deyo comorbidity index score	0.87	0.79	0.95	.003	0.91	0.82	1.00	.049
Type of index diagnosis
Alcohol (ref)	—	—	—	—	—	—	—	—
Marijuana	0.39	0.24	0.65	.001	0.57	0.32	1.03	.060
Opioids	1.76	1.20	2.57	.006	1.36	1.01	1.83	.045
Other drug	0.65	0.48	0.88	.009	0.79	0.56	1.11	.161

Note. aOR = adjusted odds ratio; CI = confidence interval.

*Engagement was estimated among all patients who initiated AOD treatment within each setting.