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Brief Reports   |    
Health Insurance Coverage and the Receipt of Specialty Treatment for Substance Use Disorders Among U.S. Adults
Janet R. Cummings, Ph.D.; Hefei Wen, B.A.; Alexis Ritvo, M.D.; Benjamin G. Druss, M.D., M.P.H.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300443
View Author and Article Information

Dr. Cummings, Ms. Wen, and Dr. Druss are with the Department of Health Policy and Management, and Dr. Druss is Rosalynn Carter Chair in Mental Health at the Rollins School of Public Health, Emory University, Atlanta, Georgia (e-mail: jrcummi@emory.edu). Dr. Ritvo is with the Department of Psychiatry, University of Colorado at Denver School of Medicine.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  The study examined the association between private health insurance and the receipt of specialty substance use disorder treatment.

Methods  Weighted logistic regressions were estimated to examine the association between health insurance and the receipt of any specialty substance use disorder treatment in national samples of nonelderly adults with alcohol abuse or dependence (N=22,778), alcohol dependence (N=10,104), drug abuse or dependence (N=9,427), and drug dependence (N=6,736). Receipt of any specialty substance abuse treatment was compared among the uninsured and privately insured persons who reported known coverage, no coverage, or unknown coverage for alcohol and drug abuse treatment. Regressions adjusted for sociodemographic characteristics, treatment need, criminal justice involvement, and year of survey.

Results  Compared with being uninsured, private insurance was associated with greater use of any specialty substance use disorder treatment only among those with alcohol dependence with known coverage for alcohol treatment (p<.05).

Conclusions  Private insurance was associated with increased use of specialty treatment among persons with severe alcohol use disorders who knew they had coverage for alcohol abuse treatment.

Abstract Teaser
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Anchor for Jump
Table 1Health insurance status and the receipt of any specialty substance abuse treatment among nonelderly U.S. adults with substance use disordersa
Table Footer Note

a Source: National Survey of Drug Use and Health, 2005–2009. Weighted logistic regressions examined the association between insurance status and the receipt of specialty treatment for substance use disorders. These models adjusted for sociodemographic characteristics, treatment need, criminal justice involvement, and year of survey.

Table Footer Note

b Weighted percentage of sample by type of insurance coverage

Table Footer Note

c Marginal effect (in percentages) of insurance status on specialty treatment, estimated relative to the reference group—persons with no health insurance—with other covariates held at their observed values. Pct0 is a model-based predicted percentage of receiving any specialty treatment for substance use among those with no health insurance, with other covariates held at their observed values.

Table Footer Note

*p<.05, **p<.01, ***p<.001

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