Town Machell, Naimi Timothy S, Mokdad Ali H, Brewer Robert D
Behavioral Surveillance Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga, USA.
Prev Chronic Dis. 2006 Apr;3(2):A53. Epub 2006 Mar 15.
Excessive alcohol consumption kills approximately 75,000 people annually in the United States. Although alcohol screening among primary care patients is recommended by the U.S. Preventive Services Task Force, it is rarely performed. It is unclear whether low screening rates are due to limited access to health care, missed screening opportunities during patient visits, or both.
Data came from the 2002 Behavioral Risk Factor Surveillance System, a population-based telephone survey of noninstitutionalized U.S. adults. Current health insurance status and a history of a recent medical checkup (within 2 years) were assessed in relation to alcohol consumption status. Excessive drinkers included those who reported binge drinking (consuming five or more drinks on one or more occasions in the past month), heavy drinking (consuming more than 60 drinks in the past month for men or more than 30 for women), or both.
The prevalence of excessive drinking among the general population (17%) was only slightly higher than the prevalence among those with current health insurance (15%) or a recent checkup (14%). Among excessive drinkers, 79% had current health insurance and 78% had a recent checkup. Although excessive drinkers were somewhat less likely to have health insurance or a recent checkup compared with nonexcessive drinkers and nondrinkers, these differences were less pronounced after stratifying by age. Excessive drinkers with the lowest rates of health insurance were young, Hispanic, less educated, and unemployed. However, most excessive drinkers who lacked insurance or a checkup were employed.
Most excessive drinkers were insured and had a recent medical checkup, suggesting that low screening rates among excessive drinkers are mostly due to missed screening opportunities rather than a lack of screening opportunities. Systems approaches to address these missed opportunities should be aggressively implemented.
在美国，每年约有75,000人死于过度饮酒。尽管美国预防服务工作组建议对初级保健患者进行酒精筛查，但实际很少进行。目前尚不清楚筛查率低是由于获得医疗保健的机会有限、患者就诊期间错过筛查机会，还是两者兼而有之。
数据来自2002年行为危险因素监测系统，这是一项针对美国非机构化成年人的基于人群的电话调查。评估了当前的健康保险状况以及近期（两年内）的体检史与饮酒状况的关系。过度饮酒者包括那些报告有暴饮行为（过去一个月内有一次或多次一次饮用五杯或更多酒）、重度饮酒（过去一个月内男性饮用超过60杯，女性饮用超过30杯）或两者皆有的人群。
普通人群中过度饮酒的患病率（17%）仅略高于有当前健康保险的人群（15%）或近期进行过体检的人群（14%）。在过度饮酒者中，79%有当前健康保险，78%近期进行过体检。尽管与非过度饮酒者和不饮酒者相比，过度饮酒者拥有健康保险或近期进行过体检的可能性略低，但按年龄分层后，这些差异并不那么明显。健康保险率最低的过度饮酒者为年轻、西班牙裔、受教育程度较低且失业的人群。然而，大多数没有保险或未进行体检的过度饮酒者都有工作。
大多数过度饮酒者都有保险且近期进行过体检，这表明过度饮酒者筛查率低主要是由于错过筛查机会，而非缺乏筛查机会。应积极实施系统性方法来解决这些错过的机会。
