title: Health services usage by Alaskan injection drug users.
abstract: OBJECTIVE
  The purpose of this study was to explore health services usage among injection drug users in Anchorage, Alaska.
  
  
  METHODS
  645 participants were recruited as part of a federally funded study of needle exchanges. They completed a health services usage questionnaire that elicited information on use of a health care provider (physician or nurse) and emergency room services. Chi-square and t-tests were used for the bivariate analyses, and multiple logistic regression was used to develop the final predictive models.
  
  
  RESULTS
  The majority of respondents (n = 646) were male (77 percent). Race/ethnicity included 58 percent White, 22 percent Alaska Native, and 20 percent African American. The multivariate model predicting accessing a health care provider (HCP) included ever having had chlamydia (OR 2.7, CI 1.6, 4.5), current income from welfare or public assistance (OR 2.6, CI 1.7, 3.9), current income from disability (OR 5.0, CI 2.2, 11.4), current income from SSI (OR .30, CI .12, .77) and the number of days in the last 30 used opiates other than heroin (OR 1.04, CI 1.002, 1.078). The multivariate model predicting use of an emergency room (ER) was similar to that predicting use of an HCP, with the additional finding of a negative association between being African American and ER use.
  
  
  CONCLUSIONS
  The role of public assistance benefits enabling access to health care for IDUs has policy implications. Large public programs, such as the Indian Health Service, paid for much of the health care received by the IDUs recruited as part of this study.
authors.affiliation: Center for Behavioral Research and Services, California State University, 1090 Atlantic Avenue, Long Beach, CA 90813, USA. greynol2@csulb.edu
authors.forename: Grace L
authors.initials: GL
authors.lastname: Reynolds
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Wells
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Fisher
authors.forename: Henry H
authors.initials: HH
authors.lastname: Cagle
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000413:Alaska / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D018671:Needle-Exchange Programs; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011632:Public Assistance; D015819:Substance Abuse, Intravenous / Q000208:ethnology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data