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Association Between Hospital Adoption of an Emergency Department Treatment Pathway for Opioid Use Disorder and Patient Initiation of Buprenorphine After Discharge

Emergency department (ED)–based initiation of buprenorphine has been shown to increase engagement in outpatient treatment and reduce the risk of subsequent opioid overdose; however, rates of buprenorphine treatment in the ED and follow-up care for opioid use disorder (OUD) remain low in the U.S. In response to high opioid overdose death rates, the Pennsylvania Department of Human Services (DHS) implemented the Opioid Hospital Quality Improvement Program (O-HQIP) in 2019. The O-HQIP is the first statewide financial incentive program designed to increase engagement in OUD treatment, including buprenorphine treatment, for Medicaid-enrolled patients who have ED encounters. This cohort cohort study of 17, 428 Medicaid-enrolled patients demonstrated that the O-HQIP was associated with an increased initiation of buprenorphine in patients with OUD presenting to the ED. These findings suggest that statewide incentive programs may effectively improve outcomes for patients with OUD.

Published March 24, 2023

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