RESUMO
Objectives. To examine the impact of health insurance coverage on utilization of outpatient, hospital, and emergency department care among justice-involved individuals in the United States.Methods. We performed repeated cross-sectional analyses with data from the National Survey of Drug Use and Health. The study population included 6086 adults with justice involvement within the past year. We used logistic regression to examine the odds of health care utilization based on either a dichotomous or categorical measure of health insurance coverage. We used negative binomial regression to examine the number of times a specific type of care was utilized with both a dichotomous measure of health insurance coverage and a categorical measure of type of health insurance.Results. Health insurance was associated with increased utilization of outpatient, inpatient, and emergency department care.Conclusions. Health insurance coverage was associated with increased utilization of outpatient, inpatient, and emergency department health care among justice-involved individuals. Therefore, expanding access to health insurance in this population has the potential to increase care utilization of all types and decrease barriers to medical services.
Assuntos
Direito Penal/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Estudos Transversais , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Estados Unidos/epidemiologia , Populações Vulneráveis , Adulto JovemRESUMO
We report a rare case of anterior spinal artery syndrome in the setting of acute cocaine use. A 31-year-old man presented to the hospital unarousable with leukocytosis and a positive toxicology screen for opioids, cocaine, benzodiazepines and cannabis. He was placed on intravenous naloxone. As the patient regained consciousness, he was found to have paraplegia, sensory loss below the level of T5, and urinary retention. MRI findings showed a signal intensity abnormality from the level of T1-4, highly suggestive of an acute ischemic spinal cord infarct. [Full article available at http://rimed.org/rimedicaljournal-2018-02.asp].