title: Private insurance and the utilization of chemical dependency treatment.
abstract: This study examines how different types of health coverage influence the likelihood of entering treatment for an alcohol problem, and the extent that people in treatment are able to use their insurance to help cover the costs of care. Survey data are analyzed from a sample of problem drinkers drawn from the general population and chemical dependency treatment programs in the same community. We find that, in comparison to being on Medicaid and being uninsured, having private coverage does not significantly alter the odds of treatment entry. Being in a private managed care plan, as compared to traditional indemnity coverage, also does not appear to impact the chances of treatment entry. However, having private coverage, as compared to being on Medicare, doubles the odds of treatment entry. For problem drinkers who obtain treatment, those with private coverage are as or more likely than other insured groups to report that insurance helped to pay treatment expenses. Even so, 10% of those privately insured report having paid for all of their treatment costs out of pocket. We conclude that, while prior studies have rarely found that having insurance significantly impacts alcohol treatment entry, the type of coverage one possesses may matter in some cases. Our results concerning Medicare coverage may point to potential problems with making treatment affordable to some problem drinkers outside the private insurance system.
authors.affiliation: Alcohol Research Group, Public Health Institute, Berkeley, CA 94709, USA. lschmidt@arg.org
authors.forename: Laura A
authors.initials: LA
authors.lastname: Schmidt
authors.forename: Constance M
authors.initials: CM
authors.lastname: Weisner
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000191:economics / Q000534:rehabilitation*; D002140:California; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D019458:Insurance Coverage; D007358:Insurance, Psychiatric; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs; D008484:Medicaid; D006278:Medicare; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D017149:Private Sector; D016320:Substance Abuse Treatment Centers / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States