Skip to main content
SpringerLink
Log in

Problem Drinking, Health Services Utilization, and the Cost of Medical Care

  • Chapter
Alcoholism

Part of the book series: Recent Developments in Alcoholism ((RDIA,volume 15))

Abstract

The purpose of this study was to examine the relationships between problem drinking, health services utilization, and the cost of medical care in a community-based setting. In addition to descriptive analyses, these relationships were estimated with multivariate regression models. Data were collected in 1996 and 1997 through a standardized self-administered questionnaire designed to obtain important information on demographics, health status, morbidity, health care utilization, drug and alcohol use, and related lifestyle behaviors. The survey instrument also included the 10-item Michigan Alcoholism Screening Test (MAST-10), which was used to identify problematic alcohol users (PAUs). The empirical findings indicated that PAUs had a significantly higher number of outpatient visits, more emergency room episodes, and more admissions to a hospital than a combined group of nondrinkers and nonproblematic alcohol users (NPAUs). Analyses of total health care cost showed that the estimated differential in total cos t for PAUs during the past year, including the interaction effect with problematic drug use, was $367. The total cost (full effect) for PAUs was composed of a main effect ($984) and an interaction effect (-$617). These findings have implications for substance abuse interventions and health care policy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Office of National Drug Control Policy (ONDCP): The National Drug Control Strategy. Washington, DC, The White House, 1995.

    Google Scholar 

  2. Skinner HA: The Drug Abuse Screening Test. Addict Behav 7:363–371, 1982.

    Article  PubMed  Google Scholar 

  3. Skinner HA: The Drug Abuse Screening Test (DAST): Guidelines for Administration and Scoring. Toronto, Ontario, Canada, Addiction Research Foundation, 1982.

    Google Scholar 

  4. French MT, McGeary KA, Chitwood DD, McCoy CB: Chronic illicit drug use, health services utilization, and the cost of medical care. Soc Sci Med 50(12): 1703–1713, 2000.

    Article  PubMed  Google Scholar 

  5. French MT, Roebuck MC, McGeary KA, Chitwood DD, McCoy CB: Using the Drug Abuse Screening Test (DAST-10) to analyze health services utilization and cost for substance abusers in a community-based setting. Subst Use Misuse (in press).

    Google Scholar 

  6. Pokorny DA, Byron AM, Kaplan HB: The Brief MAST A shortened version of the Michigan Alcoholism Screening Test. Am JPsychiatry 129:342–345, 1972.

    Google Scholar 

  7. Zung JB: Psychometric properties of the MAST and two briefer versions. J Stud Alcohol 40:845–859, 1979.

    PubMed  Google Scholar 

  8. Manning WG, Keeler EB, Newhouse JP, Sloss EM, Wasserman J: The taxes of sin: Do smokers and drinkers pay their way? JAMA 261:1604–1609, 1989.

    Article  PubMed  Google Scholar 

  9. Holder HD, Blose JO: The reduction of health care costs associated with alcoholism treatment: A 14-year longitudinal study. J Stud Alcohol 53:293–302, 1992.

    PubMed  Google Scholar 

  10. Harwood JH, Fountain D, Livermore G: The Economic Costs of Alcohol and Drug Abuse in the United States. National Institute of Health (NIH), Publication no. 98-4327. Bethesda, MD, 1998.

    Google Scholar 

  11. Grossman M: On the concept of health capital and the demand for health. J Polit Economy 80:223–225, 1972.

    Article  Google Scholar 

  12. Grossman M: The Demandfor Health: A Theoretical and Empirical Investigation. New York, Columbia University Press for the National Bureau of Economic Research, 1972.

    Google Scholar 

  13. Grossman M: The Human Capital Model of the Demand for Health. New York, Columbia University Press for the National Bureau of Economic Research. Working Paper 7078, 1999.

    Google Scholar 

  14. Rosenzweig MR, Schultz TP: Estimating a household production function: Heterogeneity, the demand for health inputs and their effects on birth weight. JPolit Economy 91:723–746, 1983.

    Article  Google Scholar 

  15. Folland S, Goodman AC, Stano M: The Economics of Health Care. Englewood Cliffs, NJ, Prentice Hall, 1993.

    Google Scholar 

  16. Phelps CE: Health Economics. NY, Harper Collins, 1992.

    Google Scholar 

  17. Getzen TE: Health Economics: Fundamental and Flow of Funds. NY, John Wiley and Sons, 1997.

    Google Scholar 

  18. Manning WG, Keeler EB, Newhouse JP, Sloss EM, Wasserman J (eds): The Costs of Poor Health Habits. Cambridge, MA, Harvard University Press, 1991.

    Google Scholar 

  19. Selzer LM: The Michigan Alcoholism Screening Test (MAST): The quest for a new diagnostic instrument. Am J Psychiatry 127:1653–1658, 1971.

    PubMed  Google Scholar 

  20. Selzer LM, Vinokur A, van Rooijen L: A self-administered Short Michigan Alcoholism Screening Test (SMAST). J Stud Alcohol 36:117–126, 1975.

    PubMed  Google Scholar 

  21. Bohn MJ, Babor TF, Kranzler HR: Validity of the Drug Abuse Screening Test (DAST-10) in inpatient substance abusers [Monograph]. Problems of Drug Dependence 199,1991, pp 233–235.

    Google Scholar 

  22. Gavin DR, Ross HE, Skinner HA: Diagnostic validity of the Drug Abuse Screening Test in the assessment of DSM-III drug disorders. Brit J Addict 84:301–307, 1989.

    Article  Google Scholar 

  23. Saltstone R, Halliwell S, Hayslip M: A multivariate evaluation of the Michigan Alcoholism Screening Test and the Drug Abuse Screening Test in a female offender population. Addict Behav 19(5):455–462, 1994.

    Article  PubMed  Google Scholar 

  24. Skinner H, Goldberg AE: Evidence for a drug dependence syndrome among narcotic users. Brit J Addict 81:479–484, 1986.

    Article  Google Scholar 

  25. Cocco KM, Carey KB: Psychometric properties ofthe Drug Abuse Screening Test (DAST) in psychiatric patients. Psychol Assessment 4:408–414, 1998.

    Article  Google Scholar 

  26. Staley D, El-Guebaly B: Psychometric properties ofthe Drug Abuse Screening Test (DAST) in a psychiatric patient population. Addict Behav 15:257–264, 1990.

    Article  PubMed  Google Scholar 

  27. Greene WH: Econometric Analysis, 3rd ed. New Jersey, Prentice Hall, 1997.

    Google Scholar 

  28. Cameron A, Trivedi P: Regression based tests for over-dispersion in the Poisson model. J Econometrics 46:347, 1990.

    Article  Google Scholar 

  29. Econometric Software, Inc: LIMDEP, Version 7.0, User’s Manual. Plainview, NY, 1995.

    Google Scholar 

  30. Vuong Q: Likelihood ratio tests for model selection and non-nested hypotheses. Econometrica 57:307, 1989.

    Article  Google Scholar 

  31. Manning WG, Duan N, Rogers WH: Monte Carlo evidence on the choice between sample selection and two-part models. J Econometrics 35:59–82, 1987.

    Article  Google Scholar 

  32. McGeary KA, French MT Illicit drug use and emergency room care. Health Serv Res 35(1):153–169, 2000.

    PubMed  Google Scholar 

  33. Mullahy J: Much ado about two: Reconsidering the two-part model in health econometrics. J Health Econ 17:247–281,1998.

    Article  PubMed  Google Scholar 

  34. Norton EC, Lindrooth RC, Ennett ST: Controlling for the endogeneity of peer substance use on adolescent alcohol and tobacco use. Health Econ 7:439–453, 1998.

    Article  PubMed  Google Scholar 

  35. Bollen KA, Guilkey DK, Mroz TA: Bivariate outcomes and endogenous explanatory variables: Tests and solutions with an application to the demand for contraceptive use in tunisia. Demography 32(1):111–131, 1995.

    Article  PubMed  Google Scholar 

  36. Davidson R, MacKinnon JG: Estimation and Inference in Econometrics. NY, Oxford University Press, 1993.

    Google Scholar 

  37. Bound J, Jaeger DA, Baker RM: Problems with instrumental variables estimation when the correlation between the instruments and the endogenous explanatory variable is weak. JASA 90:443–450, 1995.

    Google Scholar 

  38. Shea J: Instrument relevance in multivariate linear models: A simple measure. Rev Econ Statist 79(2):348–352,1997.

    Google Scholar 

  39. Godfrey LG, Hutton JP: Discriminating between errors-in-variables/simultaneity and misspecification in linear regression models. Econ Letters 44:359–364, 1994.

    Article  Google Scholar 

  40. Hausman JA: Specification tests in econometrics. Econometrica 46:1251–1271, 1978.

    Article  Google Scholar 

  41. Hausman JA: Specification and estimation of simultaneous equation model, in Griliches Z, Intriligator MD (eds): Handbook of Econometrics, vol 1. Amsterdam, North Holland, 1983.

    Google Scholar 

  42. Mullahy J, Sindelar JL: Alcoholism, work, and income. J Labor Econ 11:494–520, 1993.

    Article  Google Scholar 

  43. Alexandre PK, French MT Community-based relationships between chronic drug use and labor supply. University of Miami, Working Paper, 1999.

    Google Scholar 

  44. Rivers J, Komaroff E, Kibort AC: Access to health and human services for drug users: An urban/ rural community system perspective. Subst Use Misuse 34:707–725, 1999.

    PubMed  Google Scholar 

  45. Dennis ML, Senay M, White W, Webber R, Moran M, Sodetz A: Global Appraisal of lndividual Needs (GAIN) Manual. Volume I: Administration, Scoring, and Interpretation. Bloomington, IL, Lighthouse Publications, 1996.

    Google Scholar 

  46. McLellan TA, Luborsky L, Cacciola J, Griffith J, Evans F, Barr HL, O’Brien CP: New data from the Addiction Severity Index: Reliability and validity in three centers. JNerv Ment Dis 173:412–423, 1985.

    Article  Google Scholar 

  47. SAMHSA, Office of Applied Studies: 1994B National Household Survey on Drug Abuse. Public release codebook. Rockville, MD, SAMHSA, 1996.

    Google Scholar 

  48. Weisner C, Schmidt LA: Expanding the frame of health services research in the drug abuse field. Health ServRes 30:707–726,1995.

    Google Scholar 

  49. French MT, Martin RF: The costs of drug abuse consequences: A summary of research findings. J Subst Abuse Treat 13:453–466, 1996.

    Article  PubMed  Google Scholar 

  50. Cook JP, Moore MJ: Alcohol. New York, NBER Working Paper 6905, 1999.

    Google Scholar 

  51. Mullahy J, Sindelar JL: Employment, unemployment, and problem drinking. J Health Econ 15:409–434, 1996.

    Article  PubMed  Google Scholar 

  52. Coate D: Moderate drinking and coronary heart disease mortality: Evidence from NHANES I and the NHANES I follow-up. Am J Public Health 83:888–890, 1993.

    PubMed  Google Scholar 

  53. French MT, Zarkin GA: Is moderate alcohol use related to wages? Evidence from four worksites. J Health Econ 14:319–344, 1995.

    Article  PubMed  Google Scholar 

  54. Kannel WB, Ellison RC: Alcohol and coronary heart disease: the evidence for a protective effect. Clin Chim Acta 246:59–76, 1996.

    Article  PubMed  Google Scholar 

  55. Marmot M, Brunner E: Alcohol and cardiovascular disease: The status of the U-shaped curve. Brit Med J 303:565–568, 1991.

    Article  PubMed  Google Scholar 

  56. Shaper AG: Alcohol and mortality: A review of prospective studies. Brit J Addiction 85:837–847, 1990.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Services Research Center, University of Miami, Miami, Florida, 33136

    Pierre Kébreau Alexandre & M. Christopher Roebuck

  2. Department of Epidemiology and Public Health, and Department of Economics, and Health Services Research Center, University of Miami, Miami, Florida, 33136

    Michael T. French

  3. Health Services Research Center and Department of Sociology, University of Miami, Coral Gables, Florida, 33124-2208

    Dale D. Chitwood

  4. Health Services Research Center and Department of Epidemiology and Public Health, University of Miami, Miami, Florida, 33136

    Clyde B. McCoy

Authors
  1. Pierre Kébreau Alexandre
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Christopher Roebuck
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael T. French
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dale D. Chitwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Clyde B. McCoy
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Kluwer Academic Publishers

About this chapter

Cite this chapter

Alexandre, P.K., Roebuck, M.C., French, M.T., Chitwood, D.D., McCoy, C.B. (2002). Problem Drinking, Health Services Utilization, and the Cost of Medical Care. In: Alcoholism. Recent Developments in Alcoholism, vol 15. Springer, Boston, MA. https://doi.org/10.1007/978-0-306-47193-3_16

Download citation

  • DOI: https://doi.org/10.1007/978-0-306-47193-3_16

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-306-46441-6

  • Online ISBN: 978-0-306-47193-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation