4091.0: Tuesday, October 23, 2001 - Board 9

Abstract #19075

Who pays for health services for Alaskan IDUs?

Grace L. Reynolds, MPA1, Rebecca S. Wells, SM2, Dennis G. Fisher, PhD1, and Henry H Cagle, BS3. (1) Center for Behavioral Research and Services, California State University Long Beach--Center for Behavioral Research and Services, 1090 Atlantic Avenue, Long Beach, CA 90813, 562-495-2330, greynol2@csulb.edu, (2) IVDU Project, University of Alaska Anchorage, Anchorage, AK 99508, (3) Alaska Native Medical Center, 5300 Tudor Road, Anchorage, AK 99508

Purpose: To investigate what types of health insurance IDUs used to pay for services from physicians and emergency rooms. Methods: 653 IDUs in Anchorage Alaska were recruited into a study of health insurance status and health services usage. Multivariate logistic regression was used to model who accessed physician services and/or emergency room services. Results: The model predicting accessing physician services was ever having had chlamydia (OR 2.7, CI 1.6, 4.5), income from welfare (OR 2.6, CI 1.7, 3.9), disability income (OR 5.0, CI 2.2, 11.4), receiving SSI (OR .30, CI .12, .77) and the number of days in the last 30 used other opiates (OR 1.04, CI 1.002, 1.078). 33% of respondents who saw a physician said the services were billed to them but had not been paid, 21% indicated the Indian Health Service paid, followed by Medicaid (17%). The model predicting emergency room use was race of Black (OR .31, CI .18, .54), ever having had hepatitis B (OR 2.12, CI 1.33, 3.36), income from spouse (OR 1.6, CI 1.06, 2.31), employed (OR 1.8, CI 1.2, 2.7), income from welfare (OR 2.01, CI 1.3, 3.02), and the number of days in the last 30 used other opiates (OR 1.06, CI 1.02, 1.09). For emergency use, 24% said they paid "some other way," 16% said the Indian Health Service paid, 16% Medicaid, and 19% said it was billed to them but not paid. Conclusion: Public programs pay for the health services received by IDUs in Anchorage, Alaska.

Learning Objectives: The audience will be able to identify who pays for health services for injecting drug users in Anchorage Alaska and list barriers to access to care for this group.

Keywords: Access to Care, Injection Drug Users

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA