OBJECTIVE: This study examines the use of substance abuse and mental health services among older adults with substance use disorders. METHODS: Participants were members of Humana Cares, a subsidiary of Humana, Inc., a care management program for chronically ill Medicare Advantage members, between 2008 and 2010. All adults aged 65 and older with a substance use disorder identified with International Classification of Diseases-9 codes were included. We compared utilization of substance abuse and mental health services among participants with no psychiatric comorbidity (n = 585), with comorbid depression (n = 605), and with comorbid severe and persistent mental illness (severe and persistent mental illness, n = 95). RESULTS: Twenty-eight percent utilized substance abuse services and 36% utilized mental health services. After adjusting for covariates, comorbid depression (odds ratio = 4.27, 95% confidence interval: 3.22-5.65) and severe and persistent mental illness (odds ratio = 10.75, 95% confidence interval: 5.22-20.13) were independently associated with specialty service use (either substance abuse or mental health services). CONCLUSION: Although few chronically ill older adults with substance use disorders in this Medicare Advantage program received any specialty substance abuse or mental health services, utilization was higher among those who had concurrent psychiatric disorders.
OBJECTIVE: This study examines the use of substance abuse and mental health services among older adults with substance use disorders. METHODS:Participants were members of Humana Cares, a subsidiary of Humana, Inc., a care management program for chronically ill Medicare Advantage members, between 2008 and 2010. All adults aged 65 and older with a substance use disorder identified with International Classification of Diseases-9 codes were included. We compared utilization of substance abuse and mental health services among participants with no psychiatric comorbidity (n = 585), with comorbid depression (n = 605), and with comorbid severe and persistent mental illness (severe and persistent mental illness, n = 95). RESULTS: Twenty-eight percent utilized substance abuse services and 36% utilized mental health services. After adjusting for covariates, comorbid depression (odds ratio = 4.27, 95% confidence interval: 3.22-5.65) and severe and persistent mental illness (odds ratio = 10.75, 95% confidence interval: 5.22-20.13) were independently associated with specialty service use (either substance abuse or mental health services). CONCLUSION: Although few chronically ill older adults with substance use disorders in this Medicare Advantage program received any specialty substance abuse or mental health services, utilization was higher among those who had concurrent psychiatric disorders.
Authors: Jürgen Unützer; Wayne Katon; Christopher M Callahan; John W Williams; Enid Hunkeler; Linda Harpole; Marc Hoffing; Richard D Della Penna; Polly Hitchcock Noël; Elizabeth H B Lin; Patricia A Areán; Mark T Hegel; Lingqi Tang; Thomas R Belin; Sabine Oishi; Christopher Langston Journal: JAMA Date: 2002-12-11 Impact factor: 56.272
Authors: Wayne J Katon; Elizabeth H B Lin; Michael Von Korff; Paul Ciechanowski; Evette J Ludman; Bessie Young; Do Peterson; Carolyn M Rutter; Mary McGregor; David McCulloch Journal: N Engl J Med Date: 2010-12-30 Impact factor: 91.245