Patient Perspectives, Follow-up Patterns, and Cost-Effectiveness of a Low-Threshold Mobile Medical Unit Providing Opioid Use Disorder Care in an Urban Setting - PROJECT SUMMARY AND ABSTRACT The opioid crisis affects thousands of lives each year, despite the availability of therapies to treat opioid use disorder (OUD). Patient-level barriers (e.g. ability to seek care), healthcare system barriers (e.g. insurance), and social barriers (e.g. stigma) prevent motivated individuals from accessing medication therapy for OUD, including buprenorphine. Low-threshold approaches to delivering medication for OUD, such as mobile medical units, acknowledge and address these barriers by meeting individuals where they are. The services provided, populations served, and implementation lessons of the mobile medical units operating in city settings across the country are documented in the literature, but less is known about the patient’s opinion and/or sustainability of the mobile medical care model for delivering low-threshold OUD treatment. This research proposes to explore the patients’ opinion, utilization trends, and economic value of addressing inequities in access to OUD treatment with the mobile medical care model. The University of Illinois Chicago (UIC) Community Outreach Intervention Project (COIP) has an established low-threshold mobile medical unit that provides OUD treatment in Chicago neighborhoods with high need for such services. In the context of the UIC COIP mobile medical unit, this research aims to: (1) conduct qualitative interviews to ascertain the patients’ perspective on the mobile medical unit’s ability to address barriers to accessing treatment for OUD. (2) Identify patterns in patient follow-up with the mobile medical unit for OUD treatment and examine patient characteristics associated with certain follow-up patterns, using group-based trajectory modeling. (3) Assess the costs and population-level benefits of the mobile medical unit in an urban setting, accounting for the disproportionately higher benefit experienced by individuals who are disconnected from care, through a distributional cost-effectiveness analysis. As the mobile medical care model for OUD treatment delivery expands, ensuring efficient use of healthcare resources requires knowledge beyond the reach and services provided by mobile medical units. Though the mobile medical care model aims to minimize access barriers, a comprehensive analysis of the patients’ perceived benefits, the follow-up patterns, and the economic value of addressing inequities in access to affordable OUD care is necessary for informed implementation and/or expansion decision making.
