Thomson Reuters, Washington, DC 20008, USA.
J Subst Abuse Treat. 2013 Feb;44(2):201-7. doi: 10.1016/j.jsat.2012.05.003. Epub 2012 Jun 5.
Persons with a substance use disorder (SUD) are less likely to be insured and may have limited access to appropriate care, thereby increasing their reliance on emergency departments (EDs). We investigated whether health conditions and insurance status are significant predictors of admission to a community hospital directly from an ED visit with an SUD diagnosis. We analyzed the 2008 Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project. Lack of health insurance was disproportionately likely in ED visits that carried an SUD diagnosis, whether alcohol- or drug-related. Using regression analysis, most SUD and non-SUD diagnostic categories and many procedure categories were significantly related to subsequent hospital admission. Controlling for clinical characteristics, SUD-related ED visits covered by public or private insurance had substantially higher odds of leading to hospital admission than did uninsured visits. Policies that broaden insurance coverage may improve access to inpatient care for persons with SUDs.
患有物质使用障碍（SUD）的人不太可能获得保险，并且可能难以获得适当的治疗，从而增加了他们对急诊部门（ED）的依赖。我们研究了健康状况和保险状况是否是从 ED 就诊并伴有 SUD 诊断直接入院到社区医院的重要预测因素。我们分析了 2008 年医疗保健成本和利用项目的全国急诊部抽样调查。无论是否与酒精或药物有关，在 ED 就诊中，没有健康保险的情况在 SUD 诊断中不成比例地更为常见。使用回归分析，大多数 SUD 和非 SUD 诊断类别和许多程序类别与随后的住院治疗显着相关。在控制临床特征的情况下，由公共或私人保险承保的 SUD 相关 ED 就诊导致住院的可能性要远远高于没有保险的就诊。扩大保险范围的政策可能会改善 SUD 患者获得住院治疗的机会。
