Augmentation in Healthcare Utilization of Patients with Opioid Use Disorder After Methadone Maintenance Treatment: A Retrospective Nationwide Study

Abstract

Introduction

The health benefits of entering methadone maintenance treatment (MMT) for opioid-dependent persons may not be merely limited to therapy of opioid use disorder. We aimed to compare the healthcare utilization of MMT patients before and after MMT.

Methods

A retrospective analysis was performed using the Taiwan Illicit Drug Issue Database and the National Health Insurance Research Database (NHIRD) between 2014 and 2016. We included 1255 newly enrolled MMT patients in 2015 and randomly selected 5020 patients from NHIRD matched by age and gender as the comparison group. Changes in healthcare utilization 1 year before and 1 year after the date of the index date (MMT initiation) were compared within and between MMT and comparison groups.

Results

During the 1-year period following MMT, the hospitalization length was considerably decreased, while the number of outpatient visits, emergency department (ED) visits, and ED expenditure significantly increased in MMT patients. Multivariable linear regression with the difference-in-difference approach revealed that all the categories of healthcare utilization increased, except for a minor increase of outpatient expenditure and a slight decrease of hospitalization length for the MMT group relative to the comparison group. Increases in utilization of the departments of psychiatry and infectious diseases of the MMT patients were considerable.

Conclusion

MMT is associated with increased healthcare utilization, and departments of psychiatry and infectious diseases play substantial roles. Policy-makers should warrant access for all who need healthcare by ensuring the availability of the treatment for drug dependence.

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Acknowledgements

We thank Department of Mental and Oral Health (DMOH), Ministry of Health and Welfare, Taipei, Taiwan for the use of their Database of Substitution Therapy. Parts of this material are based on data and information compiled and provided by DMOH. However, the analyses, conclusions, opinions and statements expressed herein are those of the authors and not necessarily those of DMOH.

Funding

This study was supported in part by Ministry of Science and Technology (MOST 104-3011-F-039-001), Ministry of Health and Welfare (M05B4352), National Health Research Institutes (NP-108-GP-05), Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004), China Medical University Hospital, and China Medical University under the Higher Education Sprout Project of the Ministry of Education, Taiwan. The journal’s Rapid Service Fee was funded by the China Medical University Hospital.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Chieh-Liang Huang, I-Ju Tsai, Wen-Chi Lin, Ing-Kang Ho, Ruey-Yun Wang and Cynthia Wei-Sheng Lee declare that they have no conflict of interest.

Compliance with Ethics Guidelines

The Ethics Review Board of National Health Research Institutes in Taiwan approved this study (EC1060510-E-R1).

Data Availability

Due to constraints on the data sharing permissions of the data in Health and Welfare Data Science Center (HWDC) in Taiwan, we are not allowed to share the data for public use.

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Correspondence to Cynthia Wei-Sheng Lee.

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Huang, CL., Tsai, IJ., Lin, WC. et al. Augmentation in Healthcare Utilization of Patients with Opioid Use Disorder After Methadone Maintenance Treatment: A Retrospective Nationwide Study. Adv Ther (2021). https://doi.org/10.1007/s12325-021-01633-w

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Keywords

  • Emergency department (ED)
  • Healthcare utilization
  • Methadone maintenance treatment (MMT)