Department of Mental Health, Bloomberg School of Public Health and Department of Psychiatry, Johns Hopkins University, Baltimore, MD, United States of America.
Mailman School of Public Health, Columbia University, New York, NY, United States of America.
PLoS One. 2020 Oct 9;15(10):e0240298. doi: 10.1371/journal.pone.0240298. eCollection 2020.
Many privately insured adults with drug use disorders in the United States do not have health care coverage for drug use treatment. The Affordable Care Act sought to redress this gap by including substance use treatments as essential health benefits under new plans offered. This study used data from 11,732 privately insured adult participants of the 2005-2018 National Survey on Drug Use and Health with drug use disorders to examine trends in drug use treatment coverage and the association of coverage with receiving treatment. 37.6% of the participants with drug use disorders did not know whether their plan covered drug use treatment, with little change over time. Among those who knew, coverage increased modestly between the 2005-2013 and 2014-2018 periods (73.5% vs. 77.5%, respectively, p = .015). Coverage was associated with receiving drug use treatment (adjusted odds ratio = 2.09, 95% confidence interval = 1.61-2.72, p < .001). However, even among participants with coverage, only 13.4% received treatment. Broader coverage of drug use treatment could potentially improve treatment rates.
美国许多患有药物使用障碍的私人保险成年人没有药物使用治疗的医疗保险。《平价医疗法案》试图通过将药物使用治疗纳入新计划的基本健康福利来解决这一差距。本研究使用了来自 2005-2018 年全国药物使用与健康调查的 11732 名患有药物使用障碍的私人保险成年参与者的数据，以检查药物使用治疗覆盖范围的趋势以及覆盖范围与接受治疗的关联。有药物使用障碍的参与者中有 37.6%不知道他们的计划是否涵盖药物使用治疗，而且随着时间的推移变化不大。在那些知道的人中，覆盖范围在 2005-2013 年和 2014-2018 年期间略有增加（分别为 73.5%和 77.5%，p=0.015）。覆盖范围与接受药物使用治疗有关（调整后的优势比=2.09，95%置信区间=1.61-2.72，p<0.001）。然而，即使在有覆盖范围的参与者中，也只有 13.4%接受了治疗。更广泛的药物使用治疗覆盖范围可能会提高治疗率。
