{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:50:48Z","timestamp":1773291048845,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T00:00:00Z","timestamp":1549324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To test whether the opioid epidemic increased hospitals\u2019 offerings of substance use services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources\/Study Setting<\/jats:title><jats:p>This study employs data from the 2010 and 2015 American Hospital Association Annual Survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A multilevel, cross\u2010sectional design was utilized to examine associations between county\u2010level overdose rates and hospital substance use services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection\/Extraction Methods<\/jats:title><jats:p>The analytic sample consisted of 3365 acute care hospitals that answered pertinent survey questions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>In 2010, 334 hospitals offered inpatient opioid services and 588 hospitals offered outpatient services, compared to 327 and 577, respectively, in 2015, indicating that more hospitals dropped services than added them as overdose rates increased. Factors other than growing need weigh more heavily in hospitals\u2019 determination to offer substance use services, including resources, mission, and the presence of psychiatric facilities within their communities. Importantly, hospitals that employ medical home models had greater odds of offering outpatient substance abuse services in 2015 <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 95 percent <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> (1.54; 1.23\u20101.93; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hospitals are either not willing or equipped to increase substance use services in response to growing need.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.13116","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T04:04:03Z","timestamp":1549425843000},"page":"399-406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hospitals and substance use disorder services in the time of the opioid epidemic"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6381-9695","authenticated-orcid":false,"given":"Cory E.","family":"Cronin","sequence":"first","affiliation":[{"name":"Department of Social and Public Health Ohio University College of Health Sciences and Professions  Athens Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berkeley","family":"Franz","sequence":"additional","affiliation":[{"name":"Department of Social Medicine Ohio University Heritage College of Osteopathic Medicine  Athens Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Skinner","sequence":"additional","affiliation":[{"name":"Department of Social Medicine Ohio University College of Osteopathic Medicine  Dublin Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zelalem T.","family":"Haile","sequence":"additional","affiliation":[{"name":"Department of Social Medicine Ohio University College of Osteopathic Medicine  Dublin Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"e_1_2_7_3_1","first-page":"1","article-title":"Drug overdose deaths in the United States, 1999\u20102015","volume":"273","author":"Hedegaard H","year":"2017","journal-title":"NCHS Data Brief"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12397"},{"key":"e_1_2_7_5_1","first-page":"1","article-title":"Mortality in the United States, 2016","volume":"293","author":"Kochanek KD","year":"2017","journal-title":"NCHS Data Brief"},{"key":"e_1_2_7_6_1","unstructured":"KatzJ.Short answers to hard questions about the opioid crisis. The New York Times.2017."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-017-0178-6"},{"key":"e_1_2_7_8_1","unstructured":"AlderksCE.Trends in the use of Methadone Buprenorphine and extended\u2010release Naltrexone at substance abuse treatment facilities: 2003\u20102015 (Update). The CBHSQ Report. 2017."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.08.003"},{"key":"e_1_2_7_10_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).National survey of substance abuse treatment services: Data on substance abuse treatment facilities 2016.https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/2016_NSSATS.pdf. Accessed January 5 2018."},{"key":"e_1_2_7_11_1","unstructured":"Substance Abuse and Mental Health Services Administration.Advancing behavioral health integration within NCQA recognized patient\u2010centered medical homes. Rockville MD: SAMHSA\u2010HRSA Center for Integrated Health Solutions (CIHS) 2014.https:\/\/www.integration.samhsa.gov\/integrated-care-models\/Behavioral_Health_Integration_and_the_Patient_Centered_Medical_Home_FINAL.pdf. Accessed January 5 2018."},{"issue":"2","key":"e_1_2_7_12_1","first-page":"1","article-title":"Can substance use disorders be managed using the chronic care model? 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Accessed February 25 2018."},{"key":"e_1_2_7_16_1","first-page":"62","article-title":"Why don't hospitals prioritize substance abuse in their community benefit programming?","volume":"25","author":"Franz BA","year":"2018","journal-title":"J Public Health Man"},{"key":"e_1_2_7_17_1","unstructured":"Center for Medicare and Medicaid Services.Critical access hospital. Medical Learning Booklet. 2017.https:\/\/www.cms.gov\/Outreach-and-Education\/Medicare-Learning-Network-MLN\/MLNProducts\/downloads\/CritAccessHospfctsht.pdf. 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