Affordable transportation access to treatment for opioid use disorder

IF 6.3 2区 工程技术 Q1 ECONOMICS Transport Policy Pub Date : 2024-08-05 DOI:10.1016/j.tranpol.2024.08.001
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Abstract

Transportation is a key barrier for accessing healthcare services. This is particularly concerning for the millions suffering from opioid use disorder (OUD) since treatment for OUD can require in-person visits daily or a few times a week. To better understand how public transit influences access to treatment for OUD, we observe distances among opioid treatment programs (OTPs), buprenorphine providers, and public transit stops in the U.S. We also investigate the possible role of micromoblity, specifically bikesharing and e-scooters, in filling these transportation gaps. Results show that in urban counties, 48–91% of buprenorphine providers and OTPs are within possible walking distance (i.e., 0.4–1.4 km) of public transit stops, suggesting a high degree of heterogeneity in public transit access even among urban counties. In rural counties, only 5–40% of buprenorphine providers and OTPs are within possible walking distance of public transit stops. Given that many micromobility programs are in urban areas, they could complement public transit in urban counties where public transit runs less frequently, but not in rural counties. We also find that, on average, the odds an OTP or a buprenorphine provider is within walking distance of a public transit stop decreases outside the large central metro counties, as well as in counties that have a greater percentage of people with lower educational attainment. Affordable transportation options will continue to limit treatment options for people suffering from OUD, especially outside major metropolitan areas, unless public transit or other transportation innovations are expanded or telemedicine becomes more accessible.

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以负担得起的交通方式获得阿片类药物使用障碍的治疗
交通是获得医疗服务的主要障碍。对于数百万阿片类药物使用障碍(OUD)患者来说,这尤其令人担忧,因为 OUD 的治疗可能需要每天或每周多次亲自到医院就诊。为了更好地了解公共交通如何影响阿片类药物使用障碍的治疗,我们观察了美国阿片类药物治疗项目(OTP)、丁丙诺啡提供者和公共交通站点之间的距离。我们还调查了微型城市,特别是共享单车和电动滑板车在填补这些交通空白方面可能发挥的作用。结果显示,在城市县,48%-91%的丁丙诺啡提供者和OTP距离公交站点在可能的步行距离内(即0.4-1.4公里),这表明即使在城市县之间,公交可达性也存在高度异质性。在农村地区,只有 5-40% 的丁丙诺啡提供者和 OTP 在公交站点的步行范围之内。鉴于许多微型交通项目都在城市地区,在公共交通运行频率较低的城市县,它们可以对公共交通起到补充作用,但在农村县则不行。我们还发现,平均而言,在大都会中心区以外的大县,以及教育程度较低的人口比例较高的县,OTP 或丁丙诺啡提供者距离公交站点在步行距离之内的几率有所下降。负担得起的交通选择将继续限制 OUD 患者的治疗选择,尤其是在大都市以外的地区,除非公共交通或其他交通创新得到扩展,或者远程医疗变得更加便捷。
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来源期刊
Transport Policy
Transport Policy Multiple-
CiteScore
12.10
自引率
10.30%
发文量
282
期刊介绍: Transport Policy is an international journal aimed at bridging the gap between theory and practice in transport. Its subject areas reflect the concerns of policymakers in government, industry, voluntary organisations and the public at large, providing independent, original and rigorous analysis to understand how policy decisions have been taken, monitor their effects, and suggest how they may be improved. The journal treats the transport sector comprehensively, and in the context of other sectors including energy, housing, industry and planning. All modes are covered: land, sea and air; road and rail; public and private; motorised and non-motorised; passenger and freight.
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