4305.0: Tuesday, November 14, 2000 - 9:24 PM

Abstract #9045

Health care utilization among Baltimore needle exchange participants

Elise D. Riley, MPH, Epidemiology, Johns Hopkins School of Public Health, 627 N. Washington St., 3rd Floor, Baltimore, MD 21205, 410-614-4412, ERILEY@JHSPH.EDU, David Vlahov, PhD, Center for urban epidemiologic sutdies, New York Academy of Medicine, 1216 Fifth Ave, New York, NY 10029, Albert W. Wu, MD, MPH, Health Policy & Management, Johns Hopkins School of Public Health, 633 Hampton House, Broadway, Baltimore, MD 21205, Peter Beilenson, MD, MPH, Baltimore City Department of Health, 210 Guilford Ave., 3rd Floor, Baltimore, MD 21202, and Richard E. Chaisson, MD, MPH, Internal Medicine, Johns Hopkins School of Medicine, 1830 Mount St., Room 455, Baltimore, MD 21205.

OBJECTIVE: Drug use has been associated with lower rates of health care utilization. We studied use of drug treatment and primary care services among injection drug users who requested tuberculosis screening at two of six sites of the Baltimore Needle Exchange Program (NEP). METHODS: Between 6/98 and 5/99, participants (n=290) were interviewed about health care utilization and injection practices. Dependent variables were use of primary care and participation in drug treatment during the past 3 years. Independent variables included demographics, insurance status, drug use, and overall health. Data were analyzed using Wilcoxon rank-sum, chi-square statistics, and logistic regression. RESULTS: Median age was 41, 41% were female, 92% African-American, 39% high school graduates, and 29% had health insurance. Overall, 42% had been in drug treatment and 39% had used primary care. Drug treatment was significantly associated with being female (OR=2.2, p=0.002), below average overall health (OR=2.1, p=0.025), and having insurance (OR=2.2, p=0.003). Primary care was associated with older age (OR=1.8, p=0.26), insurance (OR=2.3, p=0.004), ever being tested for HIV (OR=4.8, p=0.002), and utilizing a homeless shelter (OR=2.3, p=0.02). CONCLUSION: In this population of drug injectors, health insurance was associated with both utilizing drug treatment and primary health care services. However, the overall rate of health insurance was low. Combining needle exchange with social services that facilitate uptake of insurance could lead to increased utilization of health care and drug treatment.

Learning Objectives: Participants of this session will be offered perspective with which to consider issues surrounding health services used by drug users

Keywords: Health Care Utilization, Needle Exchange Programs

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