The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68430

Hsiao-ye Yi, PhD, Alcohol Epidemiologic Data System, CSR, Incorporated, 2107 Wilson Blvd., Suite 1000, Arlington, VA 22201, 703-312-5220, hyi@csrincorporated.com, Chiung M. Chen, MA, Alcohol Epidemiologic Data System, CSR Incorporated, 2107 Wilson Blvd., Suite 1000, Arlington, VA 22201, and Mary C. Dufour, MD, MPH, National Institute on Alcohol Abuse and Alcoholism, NIH, Willco Building, Suite 514, 6000 Executive Boulevard, Bethesda, MD 20892-7003.

This study examines the gaps in health care coverage for hospitalizations with and without alcohol-related diagnoses.

Data for this study are drawn from the National Hospital Discharge Survey (NHDS) 2000. The NHDS collects data from a sample of non-federal, short-stay (fewer than 30 days) hospitals with six or more beds. In this study, alcohol-related diagnoses include alcoholic psychoses (ICD-9-CM: 291.0-5, 8, 9), alcohol dependence syndrome (ICD-9-CM: 303.0,9; 265.2; 357.5; 425.5; 535.3), and nondependent abuse of alcohol (ICD-9-CM: 305.0). The unit of analysis is a discharge episode. Distributions of principal payment sources are calculated for three categories of discharges: first-listed alcohol-related diagnoses, nonfirst-listed alcohol-related diagnoses, and nonalcohol-related diagnoses. The effect of alcohol-related diagnoses on the likelihood of having to pay by self (i.e., no insurance coverage) is assessed by logistic regression models adjusting for demographic characteristics.

Descriptive results indicate that about 18% of discharges with first-listed alcohol-related diagnoses had no insurance coverage while only 4% of discharges with nonalcohol-related diagnoses had no insurance coverage. This comparison varies across regions with the Northeast having the largest gap (24% vs. 4%) and the South having the smallest gap (15% vs. 5%). Logistic regression models show that, compared with discharges with nonalcohol-related diagnoses, the risk for having no insurance coverage was tripled among discharges with fist-listed alcohol-related diagnoses (OR=3.17), after adjusting for age, sex, race, marital status, and region. This increase in the risk was significantly reduced for discharges that occurred in the South (OR=1.42).

Learning Objectives:

• The findings of this study will provide valuable information on the gaps in health care coverage for hospitalizations with alcohol-related diagnoses and, thus, inform the ongoing debate about the inadequate coverage for alcohol-related treatment.

Keywords: Health Care Access, Alcohol Problems

Presenting author's disclosure statement:
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.