Using Health Insurance Claims Data to Analyze Substance Abuse Charges and Utilization

It is crucial to evaluate whether health insurance data sets will provide robust answers to significant research questions in advance of undertaking large research studies using these data. In this article, we present the research challenges of using insurance claims data sets to study substance abuse. Using illustrations from the itemized claims from three large employers, we focus on using administrative data to analyze costs to employers, utilization of services to treat abuse of specific drugs, and the effects of managed care strategies. We conclude that insurance claims data sets are useful for reporting employers' payments for treatment of identified substance abusers and for tracking changes over time but are not useful for studies of the use of treatment for specific drugs.