Justice-Involved Adults With Substance Use Disorders: Coverage Increased But Rates Of Treatment Did Not In 2014
Justice-Involved Adults With Substance Use Disorders: Coverage Increased But Rates Of Treatment Did Not In 2014
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DOI：
10.1377/hlthaff.2016.0005
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发表时间：
2016-06-01
期刊：
影响因子：
9.7
通讯作者：
Barry, Colleen L.
中科院分区：
文献类型：
--
作者：
Saloner, Brendan;Bandara, Sachini N.;Barry, Colleen L.
在刑事司法系统中，超过三分之一的美国成年人患有药物使用障碍，这会导致健康问题和累犯。过去十年启动的医疗保险和刑事司法改革为增加参与司法的个人获得治疗提供了机会。使用全国调查数据，我们检查了2004年至2014年在报告过去一年刑事司法接触并符合物质使用障碍筛查标准的成年人中治疗物质使用障碍的趋势。我们发现，从2004年到2013年，该人群的未参保率相对没有变化。2014年，也就是《平价医疗法案》(Affordable Care Act)扩大医疗补助计划的第一年，涉及司法的药物使用障碍患者的未参保率从38%下降到28%。尽管2014年的总体治疗率没有增加，但与之前十年相比，接受治疗的个人更有可能通过医疗补助来支付医疗费用。医疗补助报销可以成为提高药物使用障碍治疗的质量和连续性的关键杠杆，为涉及正义的人群提供治疗。
More than one-third of US adults in the criminal justice system have substance use disorders, which contribute to health problems and recidivism. Health insurance and criminal justice reforms initiated in the last decade offer opportunities for increasing treatment access among justice-involved individuals. Using national survey data, we examined trends in treatment of substance use disorders from 2004 to 2014 among adults who reported past-year criminal justice contact and met screening criteria for substance use disorders. We found that the uninsurance rate was relatively unchanged in that population from 2004 to 2013. In 2014, the first year of the Affordable Care Act Medicaid expansion, the uninsurance rate among justice- involved individuals with substance use disorders declined from 38 percent to 28 percent. Although overall treatment rates did not increase in 2014, individuals receiving treatment were more likely to have their care paid for by Medicaid than in the prior decade. Medicaid reimbursement can be a critical lever for improving the quality and continuity of substance use disorder treatment for justice-involved populations.