NCJ Number
195277
Journal
Medical Care Volume: 39 Issue: 11 Dated: 2001 Pages: 1158-1169
Date Published
2001
Length
12 pages
Annotation
This report presents findings from a theoretically guided study of access to inpatient or residential treatment among a probability sample of homeless adults with alcohol or drug-use disorders in Houston, Texas.
Abstract
The study used a cross-sectional, retrospective design with data collected from a multistage random sample of 797 homeless adults aged 18 or older who were living in Houston shelters and streets in 1996. Structured face-to-face interviews produced screening diagnoses for alcohol and drug use disorders, treatment use data, and candidate predictors of treatment use. Logistic and linear regression analyses were performed on the subset of 326 homeless persons with either alcohol or drug-use disorders. The study found that during the past year, 27.5 percent of persons with substance-use disorder had accessed inpatient or residential treatment during the past year. Controlling for additional need factors such as comorbidity, persons having public health insurance and a history of treatment for substance problems had greater odds of receiving at least one night of treatment. Contrary to expectation, contact with other service sectors was not predictive of treatment access. Schizophrenia and having a partner appeared to hinder access. Greater need for treatment was associated with fewer nights of treatment, suggesting retention problems. This study exposed a pattern of disparities in substance abuse treatment access. Health insurance is important, but enhancing access to care involves more than economic considerations if homeless persons are to receive the treatment they need. Referral relationships across different service sectors may require strengthening. 3 tables and 65 references