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Tami L. Mark, PhD, Outcomes Research and Econometrics, Medstat, 4301 Connecticut Avenue, NW, Washington, DC 20008, 202-719-7832, Tami.Mark@Medstat.com and Rosanna M. Coffey, PhD, The Medstat Group, 4301 Connecticut Avenue, NW, Washington, DC 20008.
OBJECTIVES: The goal of this study is to decompose underlying trends in substance abuse services received by individuals with private insurance. The study documents changes by inpatient, outpatient and pharmaceutical services in access, intensity of services, and price per unit of service. Moreover, cost-sharing trends are revealed. METHODS: Data for this study come from Medstat’s MarketScan database, which compiles claims information from private health insurance plans of large employers. The sample size was approximately four million covered lives. Covered individuals include employees, their dependents, and early retirees of companies who participate in the database. Claims for substance abuse (SA) inpatient or outpatient services were identified based on a primary diagnosis code. RESULTS: The percent using any SA services declined by 23 percent from 1992 to 2001 (from 0.65 percent of enrollees to 0.49 percent of enrollees). The percent using any services declined in all categories: inpatient, outpatient, and pharmaceutical. The percent using outpatient care declined by 17.8 percent, the percent using inpatient care by 53.3 percent, and the percent using SA pharmaceuticals by 10 percent. The intensity of outpatient care dropped, from 4.3 visits per user in 1992 to 4.1 visits per user in 2001. Mean expenditures per visit in real dollars fell by 21.8 percent. CONCLUSIONS: The provision of substance abuse services under private health insurance declined from 1992 to 2001.
Learning Objectives:
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.