title: Implications of Medicaid coverage in a program for Latino substance users.
abstract: BACKGROUND
  This cross-sectional study explored baseline differences between Medicaid covered and uninsured clients (n=368) in the Project La Voz, a community outreach program targeting Latino substance users.
  
  
  METHODS
  Independent variables included client demographics, health status and health service use; the dependent variable was Medicaid coverage vs. uninsured. Bi-variate analyses and three binomial logistic regression models were conducted.
  
  
  RESULTS
  The first logistic regression model examining client characteristics indicated that La Voz enrollees with Medicaid coverage were more likely to be women, reside in stable housing, and report poor health status. Employment and educational status were not significantly associated with having Medicaid. A second model, examining the association between health care utilization in the past 30 days and Medicaid coverage, indicated that LaVoz enrollees with Medicaid were significantly more likely to have entered substance use treatment. In the third model, client characteristics and health care use were examined in one model; all variables remained significant except for gender. IMPLICATIONS FOR PROGRAM PLANNING: Massachusetts recent health care reform efforts include substance abuse treatment benefits through Medicaid. Specific strategies are needed to ensure that Latinos substance abusers, particularly those who are homeless, gain Medicaid coverage and then have access to needed services.
authors.affiliation: Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA. sbachman@bu.edu
authors.forename: Sara S
authors.initials: SS
authors.lastname: Bachman
authors.forename: Angela W
authors.initials: AW
authors.lastname: Walter
authors.forename: Nellie
authors.initials: N
authors.lastname: Kuilan
authors.forename: Lena M
authors.initials: LM
authors.lastname: Lundgren
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000458:organization & administration / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008404:Massachusetts; D008484:Medicaid / Q000458:organization & administration*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D020380:Needs Assessment; D011336:Probability; D015397:Program Evaluation; D012016:Reference Values; D018570:Risk Assessment; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000191:economics* / Q000208:ethnology* / Q000628:therapy; D014481:United States