5089.0: Wednesday, November 15, 2000 - 12:30 PM

Abstract #17735

Entering alcohol and drug treatment: A case study of demographic, problem severity, and insurance factors

Constance Weisner1, Helen Matzgar1, Laura Schmidt2, and Tammy Tam2. (1) Department of Psychiatry, University of California, San Francisco, CA 94709, 510-450-2156, cmw@dor.kaiser.org, (2) Public Health Institute, Alcohol Research Group

This paper examines factors affecting treatment entry by studying treated and untreated substance abusers with public, private, and no insurance coverage. We used a treatment entry model, which included demographic characteristics, need, enabling, and insurance measures. Organizational and financial approaches to controlling access differ across insurance groups and may result in different population characteristics accessing services. The sample included consecutive intakes of individuals entering a county's public, HMO, and other private alcohol treatment programs (N=927) and a random sample of untreated problem drinkers (N=672) in the same county's general population. Problem drinkers within each insurance group who were entering treatment were compared with those untreated in the general population to examine characteristics predicting treatment entry in each insurance group.

Logistic regression analysis was used to compare models predicting being in the treatment sample versus the untreated sample of each of the three insurance groups. Demographic differences, such as gender, are presented. Of particular note are the findings regarding severity. For most health conditions, severity of the "condition," is one of the most important predictors of treatment entry. We found that social consequences, or "getting in trouble" were far more important than severity in impacting treatment entry. These differences, as well as demographic differences, are discussed across insurance pools. Results suggest that what determines entering treatment for substance abuse problems is different than for other health conditions, and it supports other studies of treatment populations in highlighting the role of social policy and the larger environment of problem drinkers in accessing treatment

Learning Objectives: At the conclusion of the session, the participant in this session will be able: - To understand the importance of population-based measures in studying access to treatment and treatment entry. - To understand the role of "formal" and "informal" factors in predicting treatment entry. Formal factors include medical, mental health, criminal justice, welfare, workplace, and other formal interactions. Informal factors include supportive and nonsupportive social networks and family structures. - To understand the differences between accessing treatment for substance abuse disorders and other health conditions

Keywords: Substance Abuse Treatment, Access

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 128th Annual Meeting of APHA