Chronic illicit drug use, health services utilization and the cost of medical care

Few studies have examined the relationships between drug use, health servic es utilization and the cost of medical care for a community-based sample of drug users. The purpose of this study was to analyze recently collected da ta on chronic drug users (CDUs), CDUs who were also injecting drug users (I DUs) and non-drug users (NDUs) to determine whether these groups exhibited differences in health services utilization and cost, In addition to descrip tive analyses, these relationships were estimated with multivariate regress ion models. Data were collected in 1996 and 1997 through a standardized self-reported q uestionnaire administered to individuals who were recruited through communi ty outreach activities in the USA. Annual differences in health services ut ilization between CDUs, IDUs and NDUs were estimated for three measures: nu mber of times admitted to a hospital, number of outpatient visits and numbe r of emergency room episodes. Results of this study indicate that CDUs and IDUs consumed significantly mo re inpatient and emergency care, but less outpatient services relative to N DUs. Analyses of total health care costs showed that CDUs and IDUs each gen erated about $1000 in excess services utilization per individual relative t o NDUs. This research is the first study to compare differences in health services utilization and cost among out-of-treatment drug users relative to a matche d group of non-users in a community-based setting. The findings suggest tha t health care providers and managed care organizations should consider poli cies that promote more ambulatory care and discourage emergency room and in patient care among drug users. Innovative and culturally acceptable approac hes may be necessary to provide incentives without posing unusual financial hardship. (C) 2000 Elsevier Science Ltd. All rights reserved.