| アブストラクト | INTRODUCTION: More evidence for patterns of healthcare utilisation and associated costs among people receiving opioid agonist therapy (OAT) is needed. We investigated primary and secondary healthcare usage and costs among methadone and buprenorphine recipients in England. METHODS: We conducted a cohort study using the Clinical Practice Research Datalink GOLD and Aurum databases of patients who were prescribed OAT between 1 January 2007 and 31 July 2019. The cohort was linked to Hospital Episode Statistics admitted patient care, outpatient and emergency department data, neighbourhood- and practice-level Index of Multiple Deprivation quintiles and mortality records. Negative binomial regression models were applied to estimate weighted rate ratios (wRR) of healthcare utilisation. Total and mean costs were calculated using Unit Costs of Health and Social Care and the National Healthcare Service Payment by Results National Tariffs. RESULTS: Among 12,639 patients observed over 39,016 person-years, we found higher rate of hospital admissions (wRR 1.18; 1.08-1.28) among methadone compared with buprenorphine recipients. The commonest hospital discharge diagnoses among methadone patients were infectious diseases (19.2%), mental and behavioural disorders (17.0%) and drug-related poisoning (16.5%); the three commonest among buprenorphine patients were mental and behavioural diseases (21.5%), endocrine (13.8%) and genitourinary system diseases (13.1%). Methadone patients had similar mean costs compared with buprenorphine patients (cost difference: pound539.01; 432.11-1006.69). DISCUSSION AND CONCLUSIONS: Differences in healthcare utilisation frequency for methadone versus buprenorphine recipients were observed. The differences in associated costs were mainly driven by hospital admissions. These findings offer valuable insights for optimising care strategies and resource allocation for OAT recipients. |
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| 組織名 | National Institute for Health and Care Research Greater Manchester Patient Safety;Research Collaboration, School of Health Sciences, Faculty of Biology, Medicine;and Health, University of Manchester, Manchester, UK.;Division of Pharmacy and Optometry, School of Health Sciences, Faculty of;Biology, Medicine and Health, Centre for Pharmacoepidemiology and Drug Safety,;University of Manchester, Manchester, UK.;Manchester Centre for Health Economics, University of Manchester, Manchester, UK.;Danish Centre for Health Economics, University of Southern Denmark, Odense,;Denmark.;Division of Psychology and Mental Health, School of Health Sciences, Faculty of;Biology, Medicine and Health, Centre for Mental Health and Safety, University of;Manchester, Manchester, UK. |
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