Medicaid-covered alcohol and drug treatment use among people with intellectual disabilities: evidence of disparities.
For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for Medicaid-covered people with intellectual disabilities and substance abuse (N=9,484) versus people without intellectual disabilities (N=915,070). The sociobehavioral model of healthcare use guides multivariate logistic regression analyses of substance abuse treatment utilization patterns, revealing disability-related disparities. Factors associated with utilization included being non-White, living in a nonurban area, having a serious mental illness, and living in a state with a generous Medicaid plan for substance abuse treatment. Implications relate to health policy, service delivery patterns, and the need for cross-system collaboration in the use of integrated treatment approaches.
Salem State University, School of Social Work, Salem, MA 01970, USA. eslayter@salemstate.edu
Elspeth
E
Slayter
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation*; D002648:Child; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D054625:Healthcare Disparities; D006801:Humans; D019458:Insurance Coverage; D008607:Intellectual Disability / Q000453:epidemiology / Q000534:rehabilitation*; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008484:Medicaid; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States; D014600:Utilization Review; D055815:Young Adult