Freeborn D K, Polen M R, Hollis J F, Senft R A
Kaiser Permanente Center for Health Research, Portland, OR 97227, USA.
J Behav Health Serv Res. 2000 Nov;27(4):446-53. doi: 10.1007/BF02287826.
This study examined whether a brief intervention to reduce hazardous alcohol consumption among primary care patients reduced use of medical care. In a parent, randomized controlled trial, at-risk drinkers identified in HMO outpatient waiting rooms were randomly assigned to receive usual care or brief clinician advice plus a 15-minute motivational counseling session. The current study (n = 514) examined the groups' use of outpatient and inpatient medical services during two years after intervention. Although the intervention reduced alcohol consumption at six-month follow-up, intervention and control groups made similar numbers of outpatient visits (M = 17.7 vs. 18.3, respectively; p = .47), were equally likely to be hospitalized (21.2% vs. 22.0%; p = .81), and among those hospitalized, had similar lengths of stay (4.7 vs. 6.6 days; p = .37). Although brief interventions to reduce hazardous drinking may potentially reduce medical care utilization, more evidence is needed to substantiate their practicality and cost-effectiveness.
本研究探讨了一项旨在减少初级保健患者有害酒精消费的简短干预措施是否能降低医疗保健的使用。在一项主要的随机对照试验中，在健康维护组织（HMO）门诊候诊室中识别出的高危饮酒者被随机分配接受常规护理或临床医生的简短建议以及15分钟的动机咨询课程。当前的研究（n = 514）考察了干预后两年内两组患者门诊和住院医疗服务的使用情况。尽管干预措施在六个月的随访中减少了酒精消费，但干预组和对照组的门诊就诊次数相似（分别为M = 17.7次和18.3次；p = 0.47），住院可能性相同（21.2%对22.0%；p = 0.81），并且在住院患者中，住院时间相似（4.7天对6.6天；p = 0.37）。虽然减少有害饮酒的简短干预措施可能会降低医疗保健的利用率，但需要更多证据来证实其实用性和成本效益。
