title: Health care service utilization and associated factors among heroin users in northern Taiwan.
abstract: Due to the needs of medical care, the probability of using health care service from heroin users is high. This cross-sectional study investigated the frequency and correlates of health service utilization among heroin users. From June to September 2006, 124 heroin users (110 males and 14 females, mean age: 34.2 ± 8.3 years) who entered two psychiatric hospitals (N = 83) and a detention center (N = 41) in northern Taiwan received a face-to-face interview. Therefore, socio-demographic characteristics, patterns of drug use, psychiatric comorbidities, blood-borne infectious diseases and health service utilization were recorded. The behaviors of health service utilization were classified into the frequency of out-patient department visit and hospitalization, as well as the purchase of over-the-counter drugs. During 12 months prior to interview, 79.8% of the participants attended health care service at least once. The rate of having any event in out-patients service visit, hospitalization, and over-the-counter drugs were 66.1%, 29.8% and 25.8% respectively. The frequency of health service utilization was associated with numerous factors. Among these factors, patients who were recruited from hospital and having a mood disorder were conjoint predictors of out-patient department visit, hospitalization and purchase of over-the-counter drugs. According to the results of this study, social education and routine screening for mood disorders can help heroin users to obtain adequate health care service. The findings of this study are useful references for targeting the heroin users for whom a successful intervention represents the greatest cost benefit.
authors.affiliation: Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Taiwan.
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Chen
authors.forename: Chih-Ken
authors.initials: CK
authors.lastname: Chen
authors.forename: Shih-Ku
authors.initials: SK
authors.lastname: Lin
authors.forename: Shu-Chuan
authors.initials: SC
authors.lastname: Chiang
authors.forename: Lien-Wen
authors.initials: LW
authors.lastname: Su
authors.forename: Liang-Jen
authors.initials: LJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006556:Heroin Dependence / Q000150:complications / Q000534:rehabilitation*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D004366:Nonprescription Drugs / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013624:Taiwan
chemical_list: D009294:Narcotics; D004366:Nonprescription Drugs; D008691:Methadone
keywords: DIGS; DSM-IV; Depression; Diagnostic Interview for Genetic Studies; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; HBV; HCV; HIV; IRR; MMT; Methadone maintenance treatment; NHI; National Health Insurance; Opioid; Prism; Treatment seeking; hepatitis B virus; hepatitis C virus; human immunodeficiency virus; incidence rate ratios; methadone maintenance treatment