D rug and A lcohol S ervices I nformation S ystem

The DASIS Report
March 2001
November 29, 2002

Health Insurance Status of Admissions for Substance Abuse Treatment: 1999
In Brief
● In 1999, the majority (64

T

his report looks at the health insurance status of admissions in the 1999 Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. TEDS includes a Minimum Data Set collected by nearly all States and a Supplemental Data Set collected by some States. Health insurance status is a Supplemental Data Set item on the client’s type of health insurance coverage (if any). TEDS does not record whether the health insurance covers substance abuse treatment or whether the insurance was used to pay for treatment. Only data on admissions from the 33 States or jurisdictions with a response rate of 75 percent or higher on this data element in 1999 were used for this report.1 These States or jurisdictions represented 60 percent of TEDS admissions in 1999.

percent) of substance abuse treatment admissions reported no health insurance
● The highest rate of no health

insurance was among Mexican admissions (81 percent)
● Admissions referred by an

employer or an Employee Assistance Program reported the highest percentage of private insurance (57 percent)

The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.DrugAbuseStatistics.samhsa.gov. Citation of the source is appreciated.

DASIS REPORT: HEALTH INSURANCE STATUS OF ADMISSIONS FOR SUBSTANCE ABUSE TREATMENT: 1999

November 29, 2002

Table 1. Substance Abuse Treatment Admissions, by Type of Health Insurance: 1999

Figure 1. Health Insurance Status, by Age Group: 1999
100 9 23 8 10 12 9 14 9 10 14 12

Number 521,878 105,386 115,008 76,936 819,208

Total 64 13 14 9 100

Male Female 67 13 10 10 100 56 12 23 9 100

Percent of Admissions

Type of Health Insurance None Private Medicaid Other Total

Percent
80 60 40 20 0

12 13 16 Other Medicaid Private

25 70 43 68 64

59

None

<18

1824

2534

3544

45+

Source: 1999 SAMHSA Treatment Episode Data Set (TEDS).

Types of Insurance
In 1999, the majority (64 percent) of substance abuse treatment admissions reported no health insurance (Table 1). The most frequently reported type of insurance was Medicaid, which accounted for 14 percent of admissions. Private insurance2 was reported by 13 percent of admissions. All other forms of insurance totaled 9 percent.

Age
Admissions younger than 18 were the group most likely to report health insurance (57 percent) (Figure 1). This age group also had the highest percentage of admissions with private insurance (25 percent) or Medicaid (23 percent). Admissions aged 18 to 24 years old were the group least likely to have health insurance (30 percent).

Substance of Abuse
Approximately 80 percent of admissions for abuse of stimulants had no insurance (Figure 3). Stimulant admissions were also least likely to have private insurance (6 percent) or Medicaid (8 percent). The largest percentages of private insurance coverage were among admissions for alcohol (16 percent) and marijuana (15 percent). Admissions for opiate abuse had the largest percentage of Medicaid insurance (23 percent).

Race/Ethnicity Sex Differences
Approximately 33 percent of male admissions reported some form of health insurance compared with 44 percent of female admissions (Table 1). Female admissions were more likely to report Medicaid coverage than male admissions (23 percent vs. 10 percent). There was little difference in the percentage of male and female admissions with private insurance (13 percent vs. 12 percent). Asian/Pacific Islander admissions were most likely to report private insurance (21 percent) and least likely to report no insurance (50 percent) (Figure 2). More than 70 percent of American Indian/Alaska Native admissions reported no insurance. The highest rate of no health insurance was among Mexican admissions (81 percent) (data not shown). The highest percentage with Medicaid coverage (31 percent) and the lowest percentage with private insurance (6 percent) was among Puerto Rican admissions.

Previous Treatment Episodes
About 15 percent of admissions with no previous treatment episodes for substance abuse treatment had private insurance (Figure 4). As the number of previous admissions increased, the percentage of admissions with private insurance declined steadily to 7 percent for the group with five or more previous admissions. However, as the number of previous admissions

November 29, 2002

DASIS REPORT: HEALTH INSURANCE STATUS OF ADMISSIONS FOR SUBSTANCE ABUSE TREATMENT: 1999

Figure 2. Health Insurance Status, by Race/ Ethnicity: 1999
100
Percent of Admissions

Figure 3. Health Insurance Status, by Primary Substance of Abuse: 1999
100 10 10 16 60 40 64 20 80 6 8 6 9 15 7 9 14 15 8 23 8 14

10 12 16

9 18 8

8 16 8

5 24 21

12

80 60 40

Percent of Admissions

9 9

Other Medicaid Private None

16 19

Other Medicaid Private None

80

62 20 0

65

68 50

70

69

62

61

51

White

Hispanic American Indian/ Black Asian/ Alaska Native Pacific Islander

0 Alcohol Cocaine Opiates Other Stimulants Marijuana

Percent of Admissions

for substance abuse treatment increased, the percentage of admissions with Medicaid increased from 10 percent for those with no previous admissions to 26 percent for the group with five or more previous admissions.

Figure 4. Health Insurance Status, by Number of Previous Admissions: 1999
100 11 80 60 40 64 20 0 First Time in Treatment 1-4 Previous Admissions 5 or More Previous Admissions 67 60 10 15 7 14 26 12 7 7 Other Medicaid Private None

Referral Source
More than 72 percent of admissions referred to treatment for substance abuse by the criminal justice system had no insurance (data not shown). Admissions referred by an employer or an Employee Assistance Program had the highest percentage of private insurance (57 percent), but even this group had no insurance onethird of the time.
End Notes
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The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. Approximately 1.6 million records are included in TEDS each year. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.

Health insurance is a Supplemental Data Set item reported in 1999 by 33 States and jurisdictions, including AR, AZ, CO, CT, DC, DE, FL, GA, HI, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NE, NH, NJ, ND, NV, PA, SC, TX, UT, and WY.
For the purposes of this report “Private Insurance” includes Blue Cross/Blue Shield, HMOs, and other forms of private health insurance.

The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina.
Information and data for this issue are based on data reported to TEDS through April 16, 2001. Access the latest TEDS reports at: http://www.samhsa.gov/oas/dasis.htm Access the latest TEDS public use files at: http://www.samhsa.gov/oas/SAMHDA.htm Other substance abuse reports are available at: http://www.DrugAbuseStatistics.samhsa.gov
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Office of Applied Studies www.samhsa.gov

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