Yingfeng Wu, MA, Danielle C. Ompad, PhD, Crystal Fuller, PhD, Sandro Galea, MD, MPH, DrPH, and David Vlahov, PhD. Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York City, NY 10029, 212.822.3586, ywu@nyam.org

Objective: To examine whether having health insurance increases having stable medical care providers (SMCP) and reduces emergency room (ER) utilization of young drug users in NYC. Methods: 1206 heroin, crack and cocaine users aged 15-40 years old were recruited into a community-based study. Data on health insurance, health care provider and utilization of the ER were collected using interviewer-administered surveys. SMCP is defined as having the same doctor for 2+ yrs. Logistic regression was used to determine the correlates. Results: The sample was 27% female, 57% Hispanic and 32% black. 69% had health insurance, among which 95% had Medicaid. Only 27% had a SMCP. 39% usually went to the ER when sick and 36% reported a recent ER visit (past 6 months). Among those who had a SMCP, 39% reported a recent ER visit. In multiple logistic regressions, having a SMCP was positively associated with being female (OR=2.36, 95%CI: 1.78~3.12), HIV+ (OR=2.99, 95%CI: 1.74~5.14), having insurance (OR=2.11, 95%CI: 1.53~2.91), and negatively associated with ever being homeless (OR=0.54, 95%CI: 0.39~0.75); Drug users who recently attended the ER are more likely to be white (OR=1.55, 95%CI: 1.74, 5.14), female (OR=1.46, 95%: 1.01~2.11), having insurance (OR=1.36, 95%CI: 1.04~1.28), and ever homeless (OR=2.10, 95%CI: 1.47~2.98). Conclusions: While a significant proportion of young drug users in this sample had health insurance, few of them had a SMCP, and they used the ER frequently. Insurance is insufficient to influence routine care and efforts to increase routine care in this population are needed.

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Learning Objectives:

• At the conclustion of this session, the participants will recognize that the common sense that having health insurance reduces the emergency room use does not apply to young drug users in New York City, and there is need to improve the routine care of young drug users.

Keywords: Health Care Utilization, Drug Use

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Center for Urban Epidemiologic Studies, New York Academy of Medicine
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.