One concern with altering a diagnostic algorithm is the potential exists that some people who are diagnosed under the current system may no longer qualify for a diagnosis and therefore lose insurance coverage for their treatment. In our sample, the current DSM-IV diagnostic algorithm classifies 13.3% (n=742) under alcohol abuse and 7.3% (n=408) under dependence. The alternative algorithm classified 9.1% (n=506) under abuse and 9.9% (n=554) under dependence. Thus, while the proportion of alcohol problems remains relatively constant (20.6% (n=1150) diagnosed under DSM-IV versus 19.0% (n=1060) diagnosed under the alternative algorithm), as we show above, the severity of alcohol problems characterized by each diagnostic category is more consistent and informative under the alternative algorithm.
