Bachman Sara S, Walter Angela W, Kuilan Nellie, Lundgren Lena M
Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
Eval Program Plann. 2008 Feb;31(1):74-82. doi: 10.1016/j.evalprogplan.2007.05.012. Epub 2007 Jul 7.
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.
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.
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.
本横断面研究探讨了“拉沃斯计划”中医疗补助覆盖人群与未参保人群（n = 368）之间的基线差异，该计划是一项针对拉丁裔药物使用者的社区外展项目。
自变量包括客户的人口统计学特征、健康状况和医疗服务使用情况；因变量是医疗补助覆盖情况与未参保情况。进行了双变量分析和三个二项逻辑回归模型分析。
第一个检验客户特征的逻辑回归模型表明，参加“拉沃斯计划”且有医疗补助覆盖的参与者更有可能为女性，居住在稳定住房中，并报告健康状况较差。就业和教育状况与拥有医疗补助并无显著关联。第二个模型检验了过去30天内医疗服务利用情况与医疗补助覆盖之间的关联，结果表明参加“拉沃斯计划”且有医疗补助的参与者进入药物使用治疗的可能性显著更高。在第三个模型中，在一个模型中检验了客户特征和医疗服务使用情况；除性别外，所有变量均保持显著。对项目规划的启示：马萨诸塞州近期的医疗改革努力包括通过医疗补助提供药物滥用治疗福利。需要采取具体策略来确保拉丁裔药物滥用者，尤其是那些无家可归者，获得医疗补助覆盖，进而能够获得所需服务。
