Michael Freeman

Assistant Professor of Technology and Operations Management @ INSEAD


Curriculum vitae


INSEAD

1 Ayer Rajah Avenue
Singapore 138676
Singapore



Curbing the opioid epidemic at its root: The effect of provider discordance after opioid initiation


Journal article


Katherine Bobroske, Michael Freeman, Lawrence Huan (MD), Stefan Scholtes, Anita Cattrell
Management Science, vol. 68(3), 2022 Mar, pp. 2003-2015


View PDF
Cite

Cite

APA   Click to copy
Bobroske, K., Freeman, M., (MD), L. H., Scholtes, S., & Cattrell, A. (2022). Curbing the opioid epidemic at its root: The effect of provider discordance after opioid initiation. Management Science, 68(3), 2003–2015. https://doi.org/10.1287/mnsc.2021.4252


Chicago/Turabian   Click to copy
Bobroske, Katherine, Michael Freeman, Lawrence Huan (MD), Stefan Scholtes, and Anita Cattrell. “Curbing the Opioid Epidemic at Its Root: The Effect of Provider Discordance after Opioid Initiation.” Management Science 68, no. 3 (March 2022): 2003–2015.


MLA   Click to copy
Bobroske, Katherine, et al. “Curbing the Opioid Epidemic at Its Root: The Effect of Provider Discordance after Opioid Initiation.” Management Science, vol. 68, no. 3, Mar. 2022, pp. 2003–15, doi:10.1287/mnsc.2021.4252.


BibTeX   Click to copy

@article{katherine2022a,
  title = {Curbing the opioid epidemic at its root: The effect of provider discordance after opioid initiation},
  year = {2022},
  month = mar,
  issue = {3},
  journal = {Management Science},
  pages = {2003-2015},
  volume = {68},
  doi = {10.1287/mnsc.2021.4252},
  author = {Bobroske, Katherine and Freeman, Michael and (MD), Lawrence Huan and Scholtes, Stefan and Cattrell, Anita},
  howpublished = {},
  month_numeric = {3}
}

Abstract

While medical research has addressed the clinical management of chronic opioid users, little is known about how operational interventions shortly after opioid initiation can impact a patient’s likelihood of long-term opioid use. Using a nationwide US database of medical and pharmaceutical claims, we investigate the care delivery process at the most common entry point to opioid use: the primary care setting. For patients who return to primary care for a follow-up appointment within 30 days of opioid initiation, we ask: who should revisit (and potentially revise) the opioid-based treatment plan, the initial prescriber (provider concordance) or an alternate clinician (provider discordance)? First, using a fully controlled logistic model, we find that provider discordance reduces the likelihood of long-term opioid use 12 months after opioid initiation by 31% (95% CI: [17%, 42%]). An instrumental variable analysis accounting for omitted variable and self-selection bias indicates this may be a conservative estimate of the true causal effect. Second, looking at patient activities immediately after the follow-up appointment, we find that this long-term reduction is at least partially explained by an immediate reduction in opioids prescribed after the follow-up appointment. Third, the data suggest that the benefit associated with provider discordance remains significant regardless of whether or when the patient saw their regular provider (versus another clinician) during the early stages of opioid use. Overall, our analysis indicates that systematic, operational changes in the early stages of managing new opioid patients may be a promising, and hitherto overlooked, opportunity to curb the opioid epidemic.

Share



Follow this website


You need to create an Owlstown account to follow this website.


Sign up

Already an Owlstown member?

Log in