# Impacts of Access to Services for Alcohol Use Disorders in Older Adults

> **NIH NIH R21** · UNIVERSITY OF WASHINGTON · 2024 · $242,001

## Abstract

Alcohol use disorders (AUDs) in older adults age 65+ are a substantial and rapidly growing clinical problem.
About 40% of older adults are current drinkers, 5.6 million have recently engaged in binge drinking and 1.2
million have a diagnosable AUD. This has been characterized as a “silent epidemic” because AUDs in older
adults are vastly underdiagnosed and undertreated in health care. This problem will likely broaden as the
number of older adults is expected to increase from 54 million in 2019 to 77 million by 2034. Inadequate access
to care for AUD may be a key reason for undertreatment. This is particularly relevant for older adults enrolled
in Medicare Advantage (MA) plans, who are subject to rules set by insurers regarding care utilization. These
rules include restrictions to receiving care from providers within plan networks. There is a substantial gap in
rigorous evidence characterizing the accessibility of providers of AUD care within MA plan networks, and
quantifying the effect of inadequate access on older adults' utilization of AUD care. These insights support the
long-term goal of our research, which is to guide payers and health systems increase the uptake of care for AUD
through rigorous evidence on the effects of provider networks and other managed care approaches. To advance
these goals, this R21 project will examine quantify and examine the effects of access to AUD care among older
adults enrolled in MA and will accomplish the following three specific aims: 1) describe geographical variation
in diagnosis of AUD and unmet treatment need among older adults, 2) descriptively characterize access to
providers of services for AUD among older adults, and 3) estimate the relationship between access to care and
use of care for AUD. Research in all aims will be conducted using extensive Medicare administrative and claims
data, which tracks enrollment in MA and the health service use of Medicare beneficiaries nationally. In Aim 1,
geographical variation in AUD diagnosis will be quantified using spatial mixed effects regression models.
Exploratory analyses in Aim 2 will quantify access to providers of AUD care across several measures by
utilizing comprehensive data on provider networks made available through the Robert Wood Johnson
Foundation. Multivariable regression models will be applied to identify individual and local area factors
associated with greater access to care. In Aim 3, econometric models for health care utilization will be applied
to quantify the relationship between use of AUD care and access measures generated in Aim 2. Products from
this study will provide timely data-driven insights for health care stakeholders responsible for ensuring
individuals' ability to access care for AUD meets adequate standards. Also, insights identifying the dimensions
of access to care that most strongly influence utilization will help stakeholders prioritize approaches to increase
uptake of care for AUD. Finally, the current project will genera...

## Key facts

- **NIH application ID:** 10887269
- **Project number:** 1R21AA031045-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Joseph Edwin Glass
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $242,001
- **Award type:** 1
- **Project period:** 2024-06-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10887269

## Citation

> US National Institutes of Health, RePORTER application 10887269, Impacts of Access to Services for Alcohol Use Disorders in Older Adults (1R21AA031045-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10887269. Licensed CC0.

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