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APHA Scientific Session and Event Listing

Elspeth M. Slayter, PhD, MSW, School of Social Work, Salem State College, 352 Lafayette Street, Academic Building, Salem, MA 01970, 617-686-6594, eslayter@brandeis.edu

Since the era of de-institutionalization, people with mental retardation (MR) have experienced increasing levels of participation in community life, including access to alcohol and other drugs. Forty years into this social experiment, populations with MR are aging. This is the inquiry into the treatment process for elders with MR. Using a cross-sectional design, research questions about the process of treatment among elders were examined by analyzing administrative claims for Medicaid beneficiaries aged 65+ with and without MR. Using performance measures initially developed by the Washington Circle and further adapted by the National Committee on Quality Assurance for inclusion in HEDIS, 599,658 people with AOD claims were identified. Among those with MR, 24.5% initiated treatment and 52.6% engaged in treatment, rates that were statistically lower than those of the population without MR. Elders with MR were less likely to access SA treatment than were youth or adults with MR. Predictors of access, initiation, engagement and dropout derived from multivariate logistic regression analysis are presented. Medicaid, a major source of health coverage for people with MR, also pays for up to 20% of AOD specialty treatment nationwide. Increased levels of initiation and engagement are predictive of treatment retention, which is in turn linked to better recovery outcomes, indicating an areas for improvement with service provision to both adults and the elderly with MR. Implications relate to how existing systems provide AOD-related care to this population and areas in which improvements in access to and quality of AOD treatment are needed.

Learning Objectives:

• To recognize key dropout points in accessing substance abuse treatment among the elderly population as compared to youth and adults
• To apply a set of performance measures to administrative claims data in order to assess access to substance abuse treatment among Medicaid beneficiaries

Keywords: Substance Abuse Treatment, Elderly

Presenting author's disclosure statement:

Any relevant financial relationships? No