Strashny Alexander
Recent data show that among persons who needed substance abuse treatment (SAT) and made an effort to obtain it, the most often reported reason for not receiving SAT was lack of health coverage and inability to afford the cost of treatment (38.2%). High unemployment rates have been associated with declines in the number of clients entering SAT. It has been estimated that about 9 million Americans lost their health insurance due to unemployment during the 2007 to 2009 recession. This report describes the social and economic characteristics of SAT admissions between 2006 and 2011 using Treatment Episode Data Set (TEDS) such as employment status of admissions at treatment entry and health insurance status of treatment admissions and expected source of payment by treatment admissions. Data from the National Survey of Substance Abuse Treatment Services (N-SSATS) was used to identify the types of client payment or insurance accepted by facilities and ancillary services provided by treatment facilities during the same time period. The percentage of SAT admissions reporting unemployment at treatment entry increased from 33.2% in 2006 to 41.6% in 2011; during this time, over one-third of facilities offered employment counseling or training services. Between 2006 and 2011, about 6 in 10 admissions reported having no health insurance coverage at treatment entry. Over 6 in 10 facilities offered sliding fee scales to clients who could not afford to pay for treatment. About half of admissions aged 22 or older expected to pay for their treatment using Medicaid, Medicare, or other government payment; over half of the SAT facilities accepted Medicaid between 2006 (52%) and 2011 (57%). This report shows that from 2006 to 2011, a high percentage of SAT admissions aged 22 or older lacked health insurance coverage and were not employed. In light of these economic barriers, the acceptance of Medicaid reported by a large proportion of facilities may play a crucial role in facilitating access to SAT for individuals experiencing economic hardship. As the Affordable Care Act is implemented through 2014, it is anticipated that there will be upward trends in Medicaid coverage as the program has been expanded to include those individuals who were formerly ineligible. Moreover, access to health care services for substance use is expected to improve as the previously uninsured gain health insurance coverage.
近期数据显示，在那些需要药物滥用治疗（SAT）并努力获取治疗的人群中，最常被提及的未接受SAT治疗的原因是缺乏医保覆盖以及无力承担治疗费用（38.2%）。高失业率与进入SAT治疗的患者数量下降有关。据估计，在2007年至2009年经济衰退期间，约900万美国人因失业失去了医疗保险。本报告使用治疗事件数据集（TEDS）描述了2006年至2011年期间SAT入院患者的社会和经济特征，如入院时的就业状况、治疗入院时的医疗保险状况以及治疗入院时预期的支付来源。来自全国药物滥用治疗服务调查（N - SSATS）的数据用于确定机构接受的患者支付或保险类型以及同一时期治疗机构提供的辅助服务。在治疗开始时报告失业的SAT入院患者比例从2006年的33.2%上升到2011年的41.6%；在此期间，超过三分之一的机构提供就业咨询或培训服务。在2006年至
