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{
    "pk": 18019,
    "title": "Variability in Practice of Buprenorphine Treatment by Emergency Department Operational Characteristics",
    "subtitle": null,
    "abstract": "<p><strong>Introduction:</strong> We sought to describe emergency department (ED) buprenorphine treatment variability among EDs with varying operational characteristics.</p>\n<p><strong>Methods:</strong> We performed a retrospective cohort study of adult patients with opioid use disorder discharged from 12 hospital-based EDs within a large healthcare system as a secondary data analysis of a quality improvement study. Primary outcome of interest was buprenorphine treatment rate. We described treatment rates between EDs, categorized by tertile of operational characteristics including annual census, hospital and intensive care unit (ICU) admission rates, ED length of stay (LOS), and boarding time. Secondary outcomes were ED LOS and 30-day return rates.</p>\n<p><strong>Results:</strong> There were 7,469 unique ED encounters for patients with opioid use disorder between January 2020–May 2021, of whom 759 (10.2%) were treated with buprenorphine. Buprenorphine treatment rates were higher in larger EDs and those with higher hospital and ICU admission rates. Emergency department LOS and 30-day ED return rate did not have consistent associations with buprenorphine treatment.</p>\n<p><strong>Conclusion: </strong>Rates of treatment with ED buprenorphine vary according to the operational characteristics of department. We did not observe a consistent negative relationship between buprenorphine treatment and operational metrics, as many feared. Additional funding and targeted resource allocation should be prioritized by departmental leaders to improve access to this evidence-based and life-saving intervention.</p>",
    "language": null,
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "opioid use disorder"
        },
        {
            "word": "buprenorphine"
        },
        {
            "word": "Addiction Medicine"
        }
    ],
    "section": "Behavioral Health",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4214m881",
    "frozenauthors": [
        {
            "first_name": "Grant",
            "middle_name": "",
            "last_name": "Comstock",
            "name_suffix": "",
            "institution": "Medical College of Wisconsin, Department of Emergency Medicine, Division of Medical Toxicology, Milwaukee, Wisconsin",
            "department": "None"
        },
        {
            "first_name": "Natalia",
            "middle_name": "",
            "last_name": "Truszczynski",
            "name_suffix": "",
            "institution": "University of Colorado School of Medicine, Aurora, Colorado",
            "department": "None"
        },
        {
            "first_name": "Sean",
            "middle_name": "S.",
            "last_name": "Michael",
            "name_suffix": "",
            "institution": "University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado",
            "department": "None"
        },
        {
            "first_name": "Jason",
            "middle_name": "",
            "last_name": "Hoppe",
            "name_suffix": "",
            "institution": "University of Colorado School of Medicine, Department of Emergency Medicine, Division of Medical Toxicology and Pharmacology, Aurora, Colorado",
            "department": "None"
        }
    ],
    "date_submitted": "2023-03-30T14:56:45+03:00",
    "date_accepted": "2023-03-30T14:56:45+03:00",
    "date_published": "2024-06-11T16:00:00+03:00",
    "render_galley": {
        "label": "Final Article",
        "type": "pdf",
        "path": "https://journalpub.escholarship.org/westjem/article/18019/galley/14441/download/"
    },
    "galleys": [
        {
            "label": "Layout",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18019/galley/10548/download/"
        },
        {
            "label": "Final Article",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18019/galley/14441/download/"
        }
    ]
}