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Medical Care Research and Review
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Utilization and Cost of Mental Health, Substance Abuse, and Medical Services among At-Risk Drinkers

Paul J. Nietert

Medical University of South Carolina, nieterpj{at}musc.edu

Michael T. French

University of Miami

JoAnn E. Kirchner

VA South Central Mental Illness Research, Education, and Clinical Center and University of Arkansas for Medical Sciences

Brenda M. Booth

University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System

The objective of this research was to examine whether users of mental health or substance abuse (MH/SA) services incurred greater costs for non-MH/SA services than nonusers of MH/SA services. Two years of health care utilization data were collected on 443 at-risk drinkers from six southern U.S. states. We then examined predictors of using MH/SA services and costs associated with non-MH/SA services. The results showed that use of MH/SA services was associated with female gender, military service, health insurance, and not being employed full-time. Unadjusted analyses indicated that non-MH/SA service costs were significantly higher among MH/SA service users than nonusers. However, this association did not endure in multivariable models. In fact, emergency department costs were significantly lower among MH/SA users. It is commonly assumed that users of MH/SA services are also heavy users of other medical services. Through multivariable models, this study found that overall costs of non-MH/SA services were similar between users and nonusers of MH/SA services.

Key Words: health services utilization and cost • alcoholism and addictive behavior • economic analysis

Medical Care Research and Review, Vol. 64, No. 4, 431-448 (2007)
DOI: 10.1177/1077558707301962
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