Healthcare Access and Utilization Among Persons Who Inject Drugs in Medicaid Expansion and Nonexpansion States: 22 United States Cities, 2018

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  Lewis, Rashunda ; Baugher, Amy R. ; Finlayson, Teresa ; Wejnert, Cyprian ; Sionean, Catlainn
• Corporate Authors:
  National HIV Behavioral Surveillance (NHBS) Study Group
• Description:
  Background.
  
  Medicaid expansion under the Affordable Care Act increased insurance coverage, access to healthcare, and substance use disorder treatment, for many Americans. We assessed differences in healthcare access and utilization among persons who inject drugs (PWID) by state Medicaid expansion status.
  
  Methods.
  
  In 2018, PWID were interviewed in 22 US cities for National HIV Behavioral Surveillance. We analyzed data from PWID aged 18–64 years who reported illicit use of opioids (n = 9957) in the past 12 months. Poisson regression models with robust standard errors were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were used to examine differences by Medicaid expansion status in indicators of healthcare access and utilization.
  
  Results.
  
  Persons who inject drugs in Medicaid expansion states were more likely to have insurance (87% vs 36%; aPR, 2.3; 95% CI, 2.0–2.6), a usual source of healthcare (53% vs 34%; aPR, 1.5; 95% CI, 1.3–1.9), and have used medication-assisted treatment (61% vs 36%; aPR, 1.4; 95% CI, 1.1–1.7), and they were less likely to have an unmet need for care (21% vs 39%; aPR, 0.6; 95% CI, 0.4–0.7) than those in nonexpansion states.
  
  Conclusions.
  
  Low insurance coverage, healthcare access, and medication-assisted treatment utilization among PWID in some areas could hinder efforts to end the intertwined human immunodeficiency virus and opioid overdose epidemics.
  
  
• Subjects:
  Adolescent Adult Behavioral Risk Factor Surveillance System Cross-Sectional Studies Drug Users Female Geography Health Services Accessibility HIV Infections Humans Insurance Coverage Male Medicaid Middle Aged Opioid-Related Disorders Opioid Epidemic Patient Acceptance Of Health Care Patient Protection And Affordable Care Act Substance Abuse, Intravenous United States Young Adult

  More +
• Keywords:
  Healthcare Utilization Injection Drug Use Insurance Medicaid Expansion Medication-assisted Treatment
• Source:
  J Infect Dis. 222(Suppl 5):S420-S428
• Pubmed ID:
  32877551
• Pubmed Central ID:
  PMC11290347
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  222
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:3c6edec9b43b06684c644b17b42ee74aff0b43212951be79e8dfdf72f619c03d13f90338aa874ab7ad3a2b6a1d85dcafe6e6c6d8bd9d292973d882f83a71e52b
• Download URL:
  https://stacks.cdc.gov/view/cdc/159517/cdc_159517_DS1.pdf
• File Type:
  [PDF - 367.72 KB ]