Objective. Racial/ethnic disparities in hospitalization rates among children with asthma have been documented but are not well-understood. Medicaid programs, which serve many minority children, markedly increased their use of managed care recent years. It is unknown whether racial/ethnic health or other processes exist populations. This study Medicaid-insured 5 organizations aimed to 1) compare parent-reported status and black, Latino, white 2) test the hypothesis that variations after...

Unhealthy alcohol use is a major contributor to the global burden of disease and injury. The US Preventive Services Task Force has recommended screening intervention in general medical settings since 2004. Yet less than one six adults report health care professionals discussing with them. Little known about methods for increasing implementation; different staffing models may be related implementation effectiveness. This trial compared delivery screening, brief referral specialty treatment...

Twelve-Step affiliation among adolescents is little understood. We examined 12-Step and its association with substance use outcomes 3 years post-treatment intake seeking chemical dependency (CD) treatment in a private, managed-care health plan. also the effects of social support religious service attendance on relationship.We analyzed data for 357 adolescents, aged 13-18, who entered at four Kaiser Permanente Northern California CD programs between March 2000 May 2002 completed both baseline...

<h3>Importance</h3> Excessive alcohol consumption is associated with increased incidence of several medical conditions, but few nonveteran, population-based studies have assessed levels use across conditions. <h3>Objective</h3> To examine associations between conditions and in a sample primary care patients using electronic health record data. <h3>Design, Setting, Participants</h3> This cross-sectional study used separate multinomial logistic regression models to estimate adjusted 26 2 720...

This population-based cross-sectional study analyzed electronic health record data of pregnant individuals in an integrated care delivery system California to examine changes prenatal cannabis use through self-report and urine toxicology testing during standard between 2012 (n=33,546) 2022 (n=43,415), test whether trends differed by race ethnicity or age. The prevalence increased from 5.5% (95% CI, 5.3–5.8%) 9.0% 8.7–9.2%) (adjusted ratio [aPR] 1.82, 95% 1.72–1.92), with similar increases...

Objective. Nonadherence to regular inhaled anti-inflammatory medication use is a frequent contributor poor control of persistent asthma and may result from misunderstanding the preventive role such medications. This study's aims are 1) test hypothesis that associated with decreased adherence its daily 2) identify factors increased risk misunderstanding. Study Design. A sample parents children insured by Medicaid enrolled in managed care programs Northern California, Washington, Massachusetts...

Objective. More than half of Medicaid enrollees are now in managed care. Scant information exists about which policies practice sites improve quality care Medicaid. Children with asthma a sentinel group for monitoring because they at elevated risk adverse outcomes. The objective this study was to identify practice-site and features associated Medicaid-insured children asthma. Methods. A prospective cohort 1-year follow-up conducted 5 health plans California, Washington, Massachusetts. Data...

This study examined participants at seven‐year follow‐up to assess long‐term outcomes of older women (n = 25) and men 59) ages 55 over in an outpatient addiction program. It measured demographic characteristics, alcohol drug use, psychiatric symptoms, Addiction Severity Index, treatment length, outcomes. At seven years, 76.0% reported abstinence the prior 30 days versus 54.2% men, p .05. Logistic regression analysis found that longer stay predicted abstinence. Findings indicate have better...

Objective: The purpose of this study was to examine the effects age, common life transitions, treatment, and social support on outcomes 5–9 years after alcohol other drug (AOD) treatment intake. Method: Participants were patients from a large outpatient AOD program in an integrated health plan. There 1,951 participants interviewed at intake, whom 1,646 (84%) completed one or more telephone follow-up interviews 5, 7, 9 years. Measures included use based Addiction Severity Index; treatment;...

Abstract Background and Aims The increasing trend in alcohol consumption among women, exacerbated by the COVID‐19 pandemic, is of growing concern. Screening, brief intervention, referral to treatment primary care an efficacious cost‐effective approach for unhealthy use. However, disparities exist delivery interventions sex, age race/ethnicity. This study measures intervention rates eligible patients race/ethnicity their intersectionality, context a program systematic screening adult large,...

Objectives: How best to provide ongoing services patients with substance use disorders sustain long-term recovery is a significant clinical and policy question that has not been adequately addressed. Analyzing nine years of prospective data for 991 adults who entered abuse treatment in private, nonprofit managed care health plan, this study aimed examine the components continuing model (primary care, specialty treatment, psychiatric services) their combined effect on outcomes over after...

To examine the associations between unhealthy alcohol use and risk of coronary heart disease (CHD) among women men aged 18-65 years. An observational study in an integrated healthcare system with systematic screening. We identified 432,265 primary care patients years who, 2014-2015, reported weekly intake levels. Weekly intake, categorized into below (≤14/week men; ≤7/week women) above limits (≥15/week ≥ 8/week per U.S. guidelines, heavy episodic drinking (HED, ≥5/≥4 drinks any day past 3...

This cross-sectional study analyzed associations between preconception and prenatal cannabis use first-trimester nausea vomiting in pregnancy (NVP) using data from 356,343 pregnancies a large health care system (2011–2022). Prevalence of was 11.3% (2.7% daily, 2.4% weekly, 6.3% monthly or less) 6.5% (0.7% 0.7% 1.4% less, 3.7% positive toxicology with no self-reported use), respectively. Based on International Classification Diseases diagnostic codes, 3.6% patients were diagnosed severe NVP...

Importance Addiction treatment rapidly transitioned to a primarily telehealth modality (telephone and video) during the COVID-19 pandemic, raising concerns about disparities in utilization. Objective To examine whether there were differences overall addiction utilization after policy changes pandemic by age, race, ethnicity, socioeconomic status. Design, Setting, Participants This cohort study examined electronic health record claims data from Kaiser Permanente Northern California for adults...

Background: Improving services and treatment outcomes for individuals with cooccurring alcohol drug use disorders psychiatric conditions has been a critical challenge to clinicians policy makers. This study examined 1‐year entering chemical dependency (CD) without diagnoses targeted by California parity legislation. Among those (i.e., dual‐diagnosis patients), we model including individual characteristics, services, extratreatment characteristics understand CD outcome predictors in this...

Background Unhealthy alcohol use frequently co‐occurs with psychiatric disorders; however, little is known about the relationship between disorders and consumption levels . Understanding varying of unhealthy among individuals a variety in primary care would provide valuable insight for tailoring interventions. Methods We conducted cross‐sectional study 2,720,231 adult patients screened 2014 2017 at Kaiser Permanente Northern California, using electronic health record data. Alcohol level was...

<h3>Importance</h3> Research has shown that higher activation and engagement with health care is associated better self-management. To our knowledge, the linkage intervention (LINKAGE) first to engage patients receiving addiction treatment using electronic record a patient approach. <h3>Objective</h3> examine effects of an aiming link care. <h3>Design, Setting, Participants</h3> A nonrandomized clinical trial evaluating LINKAGE vs usual by applying alternating 3-month off-and-on design over...

This study used a life-course perspective to identify and understand life events related long-term alcohol other drug (AOD) use trajectories across the span. Using purposive sample, we conducted semi-structured telephone interviews with 48 participants (n = 30 abstinent 18 non-abstinent) from longitudinal of AOD outcomes 15 years following outpatient treatment. A content analysis was using ATLAS.ti software salient themes. Caregiving for an ill or dependent family member better by...

OBJECTIVE People with type 2 diabetes vary greatly in their use of high-cost health care resources. We examined the association anxiety after accounting for depression and medical comorbidity. RESEARCH DESIGN AND METHODS Using electronic record data, we assessed past diagnosis, costs, demographics, comorbidities, control status complications during 2008–2012 143,573 adult members an integrated system diabetes. Multivariable regression models estimated associations between emergency...

Abstract Background During the COVID‐19 pandemic, specialty alcohol treatment transitioned rapidly to telehealth, which may have created barriers for some patients but increased access others. This study evaluated impact of pandemic on utilization and potential disparities. Methods We analyzed electronic health record claims data from Kaiser Permanente Northern California adults with use problems (alcohol disorder or unhealthy diagnoses) during pre‐COVID‐19 (March December 2019, n = 32,806)...

Objectives To evaluate associations between alcohol brief intervention (BI) in primary care and 12-month drinking outcomes 18-month health among adults with hypertension type 2 diabetes (T2D). Design A population-based observational study using electronic records data. Setting An integrated healthcare system that implemented system-wide screening, BI referral to treatment adult care. Participants Adult patients (N=72 979) or T2D (N=19 642) who screened positive for unhealthy use 2014 2017....