Repeal of state laws permitting denial of health claims resulting from alcohol impairment: Impact on treatment utilization.
Repeal of state laws permitting denial of health claims resulting from alcohol impairment: Impact on treatment utilization.
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DOI：
10.1016/j.drugpo.2021.103530
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Chaloupka F
中科院分区：
文献类型：
--
作者：
Azagba S;Shan L;Hall M;Wolfson M;Chaloupka F
美国许多州仍然有酒精排除法（AELs），允许保险公司拒绝因酒精损害而导致的健康索赔。有人担心这种形式的结构性污名化会影响寻求酒精治疗的行为。我们研究了取消AEL对酒精使用障碍（AUD）治疗的影响。1992年至2017年的酒精治疗入院数据来自治疗事件数据集。得出了州一级的入院治疗总数，包括仅医疗保健专业人员转诊、仅自我转诊以及自我转诊和医疗保健专业人员转诊。还计算了按健康保险状态（私人、公共和无保险）列出的入院治疗人数。该研究采用了差异中差异（DID）准实验设计。DID分析显示，与有AELs或从未有AELs的州相比，在废除AELs的州，医疗保健专业人员转诊的酒精治疗入院人数增加了16%（IRR=1.16，95% CI=1.07，1.25）。这些结果与按付款来源分析的结果一致。特别是，与没有废除AEL的州相比，在废除AEL的州，医疗保健专业人员转诊的私人保险患者的治疗入院率增加了约38%（IRR=1.38，95% CI=1.17，1.64）。然而，当考虑到特定国家的时间趋势时，研究结果不再显着。这项研究证明，取消AEL可能对AUD治疗入院人数产生重大影响。这些研究结果表明，AELs作为寻求治疗行为的障碍。
Many states in the U.S. still have Alcohol Exclusion Laws (AELs), which allow insurance companies to deny health claims resulting from alcohol impairment. There are concerns that this form of structural stigmatization affects alcohol treatment-seeking behaviors. We examined the effects of AEL repeal on treatment admissions for alcohol use disorder (AUD). Data on alcohol treatment admissions from 1992 to 2017 were obtained from the Treatment Episode Data Set. The state-level aggregate number of treatment admissions was derived, including healthcare professional referrals only, self-referrals only, and both self-referral and healthcare professional referrals. The number of treatment admissions by health insurance status (private, public, and uninsured) was also calculated. The study used a difference-in-differences (DID) quasi-experimental design. The DID analysis showed that the number of admissions for alcohol treatment from healthcare professional referrals increased 16% in the AEL repeal states compared to states with AELs or that never had AELs (IRR=1.16, 95% CI=1.07, 1.25). These results were consistent for analysis by payment sources. In particular, treatment admissions from healthcare professional referrals for patients covered by private insurance increased about 38% in states with AEL repeal (IRR=1.38, 95% CI=1.17, 1.64) compared to states without AEL repeal. However, the findings were no longer significant when the state-specific time trends were taken into account. This study documented that AEL repeal may have had a significant impact on the number of treatment admissions for AUD. These findings suggest that AELs function as a barrier to treatment-seeking behavior.
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影响因子：
5
作者：
Keyes, K. M.;Hatzenbuehler, M. L.;Hasin, D.
通讯作者：
Hasin, D.
“像其他任何疾病”？公众对精神分裂症，抑郁和酒精依赖的反应变化了十年。
DOI：
10.1176/appi.ajp.2010.09121743
发表时间：
2010-11
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Pescosolido BA;Martin JK;Long JS;Medina TR;Phelan JC;Link BG
通讯作者：
Link BG
影响因子：
4.2
作者：
Cohen, Emily;Feinn, Richard;Kranzler, Henry R.
通讯作者：
Kranzler, Henry R.
影响因子：
1.7
作者：
Farhoudian, Ali;Baldacchino, Alexander;Razaghi, Emran Mohammad
通讯作者：
Razaghi, Emran Mohammad
影响因子：
2.2
作者：
Hazlitt, Melissa;Hill, J. Bradford;Guillamondegui, Oscar D.
通讯作者：
Guillamondegui, Oscar D.