Stein M D, Bailey G L, Thurmond P, Paull N
General Medicine Research Unit, Butler Hospital, Providence, RI 02906, United States; Warren Alpert Medical School of Brown University, Providence, RI 02912, United States.
Warren Alpert Medical School of Brown University, Providence, RI 02912, United States; Stanley Street Treatment and Resources, Inc., Fall River, MA 02720, United States.
Drug Alcohol Depend. 2014 Mar 1;136:166-9. doi: 10.1016/j.drugalcdep.2013.12.016. Epub 2014 Jan 3.
We examined the rate of uninsurance among persons seeking detoxification at a large drug treatment program in Massachusetts in 2013, five years after insurance mandates.
We interviewed three hundred and forty opioid dependent persons admitted for inpatient detoxification in Fall River, Massachusetts. Potential predictors of self-reported insurance status included age, gender, ethnicity, employment, homelessness, years of education, current legal status, and self-perceived health status.
Participants mean age was 32 years, 71% were male, and 87% were non-Hispanic Caucasian. Twenty-three percent were uninsured. In the multivariate model, the odds of being uninsured was positively associated with years of education (OR=1.22, 95% CI=1.03; 1.46, p<.05), higher among males than females (OR=2.63, 95% CI=1.33; 5.20, p<.01), and inversely associated with age (OR=0.94, 95% CI=0.90; 0.98, p<.01).
Opioid dependent persons recruited from a detoxification program in Massachusetts are uninsured at rates far above the state average. With the arrival of the Affordable Care Act, drug treatment programs in Massachusetts and nationally will be important sites to target to expand health coverage.
我们调查了2013年在马萨诸塞州一个大型戒毒项目中寻求戒毒治疗的人群的未参保率，此时距离保险强制令实施已有五年。
我们对马萨诸塞州福尔里弗市340名因住院戒毒而入院的阿片类药物依赖者进行了访谈。自我报告的保险状况的潜在预测因素包括年龄、性别、种族、就业情况、是否无家可归、受教育年限、当前法律状况以及自我感知的健康状况。
参与者的平均年龄为32岁，71%为男性，87%为非西班牙裔白人。23%的人未参保。在多变量模型中，未参保的几率与受教育年限呈正相关（比值比=1.22，95%置信区间=1.03；1.46，p<0.05），男性高于女性（比值比=2.63，95%置信区间=1.33；5.20，p<0.01），与年龄呈负相关（比值比=0.94，95%置信区间=0.90；0.98，p<0.01）。
从马萨诸塞州一个戒毒项目招募的阿片类药物依赖者的未参保率远远高于该州平均水平。随着《平价医疗法案》的出台，马萨诸塞州乃至全国的戒毒项目将成为扩大医保覆盖范围的重要目标场所。
