Alcohol, drug abuse, and mental health care for uninsured and insured adults.

RAND, Santa Monica, CA 90407-2138, USA.
Health Services Research (Impact Factor: 2.49). 09/2002; 37(4):1055-66. DOI: 10.1034/j.1600-0560.2002.65.x
Source: PubMed

ABSTRACT To compare adults with different insurance coverage in care for alcohol, drug abuse, and mental health (ADM) problems.
From a national telephone survey of 9,585 respondents.
Follow-up of adult participants in the Community Tracking Study.
Self-report survey of insurance plan (Medicare, Medicaid, unmanaged, fully, or partially managed private, or uninsured), ADM need, use of ADM services and treatments, and satisfaction with care in the last 12 months. PRINCIPAL METHODS: Logistic and linear regressions were used to compare persons by insurance type in ADM use.
The likelihood of ADM care was highest under Medicaid and lowest for the uninsured and those under Medicare. Perceived unmet need was highest for the uninsured and lowest under Medicare. Persons in fully rather than partially managed private plans tend to be more likely to have ADM care and ADM treatments given need. Satisfaction with care was high in public plans and low for the uninsured.
The uninsured have the most problems with access to and quality of ADM care, relative to the somewhat comparable Medicaid population. Persons in fully managed plans had better rather than worse access and quality compared to partially managed plans, but findings are exploratory. Despite low ADM use, those with Medicare tend to be satisfied. Across plans, unmet need for ADM care was high, suggesting changes are needed in policy and practice.

1 Bookmark
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This chapter presents how best to navigate the systematized body of knowledge that constitutes women’s mental health services. The authors integrate the disparate disciplines involved in women’s mental health into a working framework focused on information-seeking behaviors.
    A public health perspective of women's mental health, Edited by Marion A. Becker, Bruce Lubotsky Levin, 01/2010: chapter Navigating the worlds of information: pages 373-390; Springer., ISBN: 978-1-4419-1525-2
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Patient Protection and Affordable Care Act seeks to improve health equity in the United States by expanding Medicaid coverage for adults who are uninsured and/or socioeconomically disadvantaged; however, when millions more become eligible for Medicaid in 2014, the health care workforce and care delivery systems will be inadequate to meet the care needs of the U.S. population. To provide high-quality care efficiently to the expanded population of insured individuals, the health care workforce and care delivery structures will need to be tailored to meet the needs of specific groups within the population.To help create a foundation for understanding the use patterns of the newly insured and to recommend possible approaches to care delivery and workforce development, the authors describe the 13-year-old experience of the Virginia Coordinated Care program (VCC). The VCC, developed by Virginia Commonwealth University Health System in Richmond, Virginia, is a health-system-sponsored care coordination program that provides primary and specialty care services to patients who are indigent. The authors have categorized VCC patients from fiscal year 2011 by medical complexity. Then, on the basis of the resulting utilization data for each category over the next fiscal year, the authors describe the medical needs and health behaviors of the four different patient groups. Finally, the authors discuss possible approaches for providing primary, preventive, and specialty care to improve the health of the population while controlling costs and how adoption of the approaches might be shaped by care delivery systems and educational institutions.
    Academic medicine: journal of the Association of American Medical Colleges 10/2013; 88(12). DOI:10.1097/ACM.0000000000000032 · 2.34 Impact Factor
  • Source

Full-text (2 Sources)

Available from
Jun 4, 2014