scholarly journals Receipt of Pharmacotherapy for Alcohol Use Disorder by Male Justice-Involved U.S. Veterans Health Administration Patients

2016 ◽  
Vol 29 (9) ◽  
pp. 875-890 ◽  
Author(s):  
Andrea K. Finlay ◽  
Ingrid Binswanger ◽  
Christine Timko ◽  
Joel Rosenthal ◽  
Sean Clark ◽  
...  

This study examined whether, among Veterans Health Administration (VHA) patients, veterans with recent or current justice involvement have equal receipt of pharmacotherapy for alcohol use disorder compared with veterans with no justice involvement. Using national VHA records, we calculated the overall and facility rates of receipt as the number of patients who received pharmacotherapy for alcohol use disorder divided by the number of patients diagnosed with an alcohol use disorder. Using a mixed-effects logistic regression model, we tested whether justice involvement was associated with pharmacotherapy receipt. Male veterans with jail/court involvement had significantly higher odds of receiving pharmacotherapy for alcohol use disorder compared with other male veterans. Justice-involved veterans had equal or better receipt of pharmacotherapy for alcohol use disorder compared with veterans with no justice involvement. Pharmacotherapy rates are low overall, suggesting that more work can be done to connect veterans to these medications.

Hand ◽  
2019 ◽  
Vol 15 (5) ◽  
pp. 608-614
Author(s):  
Alex H. S. Harris ◽  
Esther L. Meerwijk ◽  
Robin N. Kamal ◽  
Erika D. Sears ◽  
Mary Hawn ◽  
...  

Background: Carpal tunnel release (CTR) can be performed with a variety of anesthesia techniques. General anesthesia is associated with higher risk profile and increased resource utilization, suggesting it should not be routinely used for CTR. The purpose of this study was to examine the patient factors associated with surgeons’ requests for general anesthesia for CTR and the frequency of routine use of general anesthesia by Veterans Health Administration (VHA) surgeons and facilities. Methods: National VHA data for fiscal years 2015 and 2017 were used to identify patients receiving CTR. Mixed-effects logistic regression was used to evaluate patient, procedure, and surgeon factors associated with requests by the surgeon for general anesthesia versus other anesthesia techniques. Results: In all, 18 145 patients underwent CTR performed by 780 surgeons in 113 VHA facilities. Overall, there were 2218 (12.2%) requests for general anesthesia. Although some patient (eg, older age, obesity), procedure (eg, open vs endoscopic), and surgeon (eg, higher volume) factors were associated with lower odds of requests for general anesthesia, there was substantial facility- and surgeon-level variability. The percentage of patients with general anesthesia requested ranged from 0% to 100% across surgeons. Three facilities and 28 surgeons who performed at least 5 CTRs requested general anesthesia for more than 75% of patients. Conclusions: Where CTR is performed and by whom appear to influence requests for general anesthesia more than patient factors in this study. Avoidance of routine use of general anesthesia for CTR should be considered in future clinical practice guidelines and quality measures.


2012 ◽  
Vol 63 (7) ◽  
pp. 679-685 ◽  
Author(s):  
Alex H. S. Harris ◽  
Elizabeth Oliva ◽  
Thomas Bowe ◽  
Keith N. Humphreys ◽  
Daniel R. Kivlahan ◽  
...  

2021 ◽  
Vol 82 (1) ◽  
pp. 132-141
Author(s):  
Emily C. Williams ◽  
Madeline C. Frost ◽  
Anna D. Rubinsky ◽  
Joseph E. Glass ◽  
Chelle L. Wheat ◽  
...  

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