Who goes to alcohol and drug treatment? Understanding utilization within the context of insurance
Abstract
OBJECTIVE: This study assesses the differential roles of demographic characteristics, problem severity, motivational factors and insurance in entrance into alcohol and drug treatment. METHOD: A probability sample of adult problem and dependent drinkers from a Northem California county (N = 672) and consecutive adult intakes from the county's public (n = 298) and private (n = 628) alcohol and drug treatment programs. Interviewers conducted telephone screening for individuals meeting problem-drinking criteria in the general population; in-person interviews were conducted for those who screened positive, and also for individuals entering treatment. RESULTS: Insurance did not play an independent role in treatment entry. In logistic regression analysis, using a model from the medical utilization literature, black ethnicity (odds ratio [OR] = 2.98, p < .001); older age (OR = 4.67, p < .001); less education (OR = 1.81, p < .01); legal (OR = 7.46, p < .001) and work (OR = 3.57,p <.001) pressures; higher psychiatric (OR = 4.03,p <.001) and drug (OR = 3.04,p <.001) severity; and social consequences (OR = 1.35, p < .01) predicted treatment entry. Interventions from legal sources (OR = 6.22, p < .01) were related to entering treatment for the uninsured; legal (OR = 7.02, p < .001), workplace (OR = 6.01, p < .001) and family (OR = 1.62, p < .05) pressures were related for the insured. CONCLUSIONS: Social consequences, rather than severity of dependence, in both insured and uninsured probl…
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The Andersen model holds that healthcare utilization is shaped by predisposing factors, need, and enabling factors.
“We examined factors associated with utilization as conceptualized by the Andersen model of healthcare utilization (Andersen, 1995; Weisner, Matzger, Tam, & Schmidt, 2002), which proposes that utilization is determined by predisposing (e.g., race/ethnicity and other demographic factors) need (e.g., diagnoses) (Andersen, 1995) and enabling factors (e.g., benefit plan, Exchange enrollment) (Dhingra,”
From Healthcare utilization of individuals with substance use disorders following Affordable Care Act implementation in a California healthcare system (2020) · cites this paper as Weisner, Matzger, Tam, & Schmidt, 2002
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References 37 · Cited by 151
- Authors
- Weisner, C., Matzger, H., Tam, T., & Schmidt, L.
- Affiliations
- University of California, San Francisco (US)
- Venue
- Journal of Studies on Alcohol
- Publisher
- Alcohol Research Documentation, Inc.
- Published
- 2002-11
- Volume
- 63
- Issue
- 6
- Pages
- 673-682
- ISSN
- 0096-882X (ISSN-L)
- 1934-2683
- OpenAlex
- W2014904767
- Cited by
- 151
- References
- 37
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2021: 6 · 2020: 47 · 2019: 4 · 2018: 6 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 5 · 2013: 3 · 2012: 9
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Studies on Alcohol (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01 AA 09750, R01AA009750)
- National Institute on Drug Abuse
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- insurance status, uninsured population, problem drinking, alcoholism, legal intervention, workplace interventions, psychiatric comorbidity, health care access
- MeSH terms
- Adult, Age Factors, Analysis of Variance, Female, Humans, Insurance Benefits, Male, Middle Aged, Socioeconomic Factors, Chi-Square Distribution, Odds Ratio, Substance Abuse Treatment Centers, Medically Uninsured, Substance-Related Disorders
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