Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114969

Jim E. Banta, PHD, MPH, Susanne Montgomery, PhD, MPH, and James L. Kyle, MD, MDIV. School of Public Health, Loma Linda University, Nichol Hall, Room 1711, Loma Linda, CA 92350, 909 558-8729, smontgomery@llu.edu

During 2003, 6.2% of females 12 years of age and greater and 12.2% of males reported substance dependence or abuse during the prior year. Unfortunately, substance abuse is often not treated in primary care settings. Better identification and treatment would result in improved health for those patients. National Ambulatory Medical Care Survey data (1997 to 2002) were used to identify patients with a substance abuse diagnosis during non-institutional, outpatient visits to general and family practice, internal medicine, and psychiatry practitioners. Bivariate and logistic regression analyses were performed using STATA 7.0. An estimated 200 million visits per year were made to general and family practice physicians, 135 million visits to internal medicine physicians and 24 million visits to psychiatrists. A substance abuse diagnosis was recorded in only 0.9%, 0.85% and 4.98% of those visits, respectively. Among patients diagnosed by a non-psychiatrist, established patients and those with Medicare funding were less likely to have a substance abuse diagnosis. Increasing age was positively associated with diagnosis by general and family practice physicians. Internal medicine physicians were less likely to diagnosis Hispanics. Among psychiatrists, a substance abuse diagnosis was less likely among Hispanics; but more likely for males, among visits to a clinic, among established patients, and especially for visits with an injury. Outpatient physicians appear to greatly underreport substance abuse. Underreporting varies by physician specialty and by patient characteristics such as race/ethnicity and insurance status. Understanding those differences can aid in efforts to better identify and treat those suffering from substance abuse.

Learning Objectives:

• Recognize the extent of underreported substance abuse in outpatient primary care.
• Describe differences in substance abuse reporting between physician specialties.
• Identify interraction of physician specialty and patient characteristics in reporting a substance abuse diagnosis.

Keywords: Substance Abuse, Primary Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation