A Comparison of the Need for Health Care and Use of Health Care by Injection-Drug Users, Other Chronic Drug Users, and Nondrug Users

Abstract

This article compares the health care need and health care use of injection drug users, other chronic drug users, and nondrug users. Data from 1,330 non-Hispanic White, African American, and Hispanic/Latino men and women were analyzed to determine independent risk factors for two outcome variables: (a) need for health care treatment and (b) use of health care treatment. Ten independent demographic, health, and drug use variables were assessed in logistic regression models. Drug use (injection drug use or other chronic drug use), being female, having insurance, and perceived health status of very good/good or fair/poor were independently associated with increased need for health care. Injection drug use and other chronic drug use decreased the likelihood of receiving health care treatment, whereas being female, having insurance, and a perceived health status of fair/poor increased the likelihood of receiving health care.

Health Care Utilization Among Drug-Using and Non-Drug-Using Women

“…Chronic users in their study were significantly less likely than nonusers to receive services, despite an increased need for health care. Being female was also independently associated with an increased need for care in their sample, 17 further highlighting the importance of the drug-using women in our sample not receiving needed care. Results of this study corroborate their reported findings, but we also contrasted separately three frequency categories of users with nonusers.…”

“…For example, users and nonusers in our sample differed in the likelihood of failing to seek needed care only when the complete drug use history was considered (data not shown). Chitwood and colleagues 17 have demonstrated the lack of health service treatment among chronic (e.g., using illegal drugs weekly or more 37 ) drug users compared to nonusers. Chronic users in their study were significantly less likely than nonusers to receive services, despite an increased need for health care.…”

“…[13][14][15] Studies among out-of-treatment users are less common, 7,14 as are those comparing users to their nonusing counterparts. 5,13,16,17 Determinants of health, the need for health care, and access to care all have been shown to differ according to age, gender, racial or ethnic background, socio-economic status, geographic location, and various enabling conditions. [18][19][20][21][22][23][24][25][26][27][28] In this article, we address those factors that have traditionally been associated with health care utilization in previous studies, but also examine the independent and interrelated contribution of age and drug use to utilization of services among a group of potentially underserved women.…”

Trust and other Characteristics Associated with Health Care Utilization by Injection Drug Users

“…Furthermore, studying the process of health care utilization among IDUs will likely inform efforts to reduce their health problems (CDC, 2002;Chitwood et al, 1998) as well as diminish the health risks that IDUs pose to the larger community and ease the strain on emergency and follow-up care systems (CDC, 2002;French, McGeary, Chitwood, & McCoy, 2000).…”

An investigation of the determinants of adherence to highly active anti-retroviral therapy in Aboriginal men in the Downtown Eastside of Vancouver.

“…Studies have shown that those who use illicit drugs are medically underserved (Chitwood et al, 1998;Wood et al, 2004). Active drug users, even in a setting providing free HAART, experience difficulty obtaining care for HIV-related illnesses (Cunningham et al, 1995;Strathdee et al, 1998).…”