Background: Drug users often have medical and psychiatric comorbidities yet face barriers accessing primary care. We hypothesized that access to primary care tightly linked with substance abuse treatment would increase primary care utilization and decrease inpatient and emergency room (ER) utilization by drug users with Medicaid. Methods: We combined data from a prospective study of patients' health status and drug use with their complete New York State Medicaid claims for 1996-1998. Participants were enrolled in methadone treatment at baseline (10/95-9/96) with comprehensive primary care available on-site, followed for 3 years, and analyzed only if Medicaid-eligible for ³10 months/year. Health care utilization by linked care "recipients" (enrolled in the methadone/primary care program for ³50% of each year) was compared to that of "non-recipients" using multivariate regression. Results: In 1996, controlling for race, gender, and age, recipients (n=278) were 3.5 times as likely to have ³1 primary care visit in the past year, and had 7.5 more primary care visits in the past year, than non-recipients (n=156; p<0.001 for both comparisons). Recipients were less likely than non-recipients to have had an ER (OR=0.66, p=.05) or inpatient visit (OR=0.54, p=.005), and spent 4.4 fewer days hospitalized (p=.06). Similar findings obtained in 1997 and 1998. Conclusions: Enrollment in substance abuse treatment with on-site primary care is associated with greater utilization of primary care and substantially reduced use of ER and inpatient services. Future analyses will explore whether, in addition to preventing adverse health outcomes, this care model reduces costs as well.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: Optimize service delivery configuration for drug users needing substance abuse and medical treatment.
Keywords: Utilization, Drug Injectors
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.