Reynolds Grace L, Wells Rebecca S, Fisher Dennis G, Cagle Henry H
Center for Behavioral Research and Services, California State University, 1090 Atlantic Avenue, Long Beach, CA 90813, USA.
J Ethn Subst Abuse. 2006;5(2):23-34. doi: 10.1300/J233v05n02_02.
The purpose of this study was to explore health services usage among injection drug users in Anchorage, Alaska.
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.
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.
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.
本研究旨在探究阿拉斯加安克雷奇市注射吸毒者的医疗服务使用情况。
作为一项由联邦政府资助的针头交换研究的一部分，招募了645名参与者。他们完成了一份医疗服务使用调查问卷，该问卷收集了有关使用医疗保健提供者（医生或护士）和急诊室服务的信息。卡方检验和t检验用于双变量分析，多元逻辑回归用于建立最终预测模型。
大多数受访者（n = 646）为男性（77%）。种族/族裔包括58%的白人、22%的阿拉斯加原住民和20%的非裔美国人。预测使用医疗保健提供者（HCP）的多变量模型包括曾患衣原体感染（比值比2.7，置信区间1.6, 4.5）、当前来自福利或公共援助的收入（比值比2.6，置信区间1.7, 3.9）、当前来自残疾补助的收入（比值比5.0，置信区间2.2, 11.4）、当前来自补充保障收入（SSI）的收入（比值比0.30，置信区间0.12, 0.77）以及过去30天内使用除海洛因以外阿片类药物的天数（比值比1.04，置信区间1.002, 1.078）。预测使用急诊室（ER）的多变量模型与预测使用HCP的模型相似，另外还发现非裔美国人与ER使用之间存在负相关。
公共援助福利在使注射吸毒者能够获得医疗保健方面所起的作用具有政策意义。大型公共项目，如印第安卫生服务局，为本研究招募的注射吸毒者所接受的大部分医疗保健费用买单。
