Cherpitel Cheryl J, Ye Yu
Alcohol Research Group, Emeryville, California.
Alcohol Clin Exp Res. 2015 Sep;39(9):1698-704. doi: 10.1111/acer.12801. Epub 2015 Jul 24.
While alcohol-related problems have been found to be overrepresented in clinical samples of patients, less is known about health services utilization in the general population.
To explore the association of risky drinking and alcohol use disorders (AUD) with inpatient and outpatient services utilization, data are analyzed from a merged sample of 13,165 respondents in the 2005 and 2010 U.S. National Alcohol Surveys. Propensity score weighting was used to minimize potential bias associated with the heterogeneity in individual-level characteristics across respondents which might influence these relationships.
No significant differences were found between risky and nonrisky drinkers on any of the utilization variables in the last year, with 11% reporting an emergency room (ER) visit, a third reporting a primary care visit, and 6.2 to 7.6% reporting hospitalization. Those with an AUD were significantly more likely than those without to report an ER visit in the last year (18.2% vs. 11.6%; p = 0.003) as well as a greater number of such visits (p = 0.007), and to report more primary care visits (p = 0.05) and any hospitalization (11.2% vs. 6.7%; p = 0.019).
The data suggest a significant and potentially costly increase in health services utilization due to AUD. ERs and primary care settings would benefit from devoting increased resources to addressing AUD, which could result in clinical benefits of improvement in overall health status as well as economic benefits in lowering healthcare costs for both patients and society as a whole.
虽然在患者的临床样本中发现与酒精相关的问题占比过高,但对于普通人群的医疗服务利用情况了解较少。
为了探究危险饮酒和酒精使用障碍(AUD)与住院和门诊服务利用之间的关联,对2005年和2010年美国国家酒精调查中13165名受访者的合并样本数据进行了分析。倾向得分加权用于尽量减少因受访者个体特征异质性可能影响这些关系而产生的潜在偏差。
在去年的任何一项利用变量上,危险饮酒者和非危险饮酒者之间均未发现显著差异,11%的人报告去过急诊室,三分之一的人报告进行过初级保健就诊,6.2%至7.6%的人报告住院治疗。患有AUD的人比未患AUD的人在去年更有可能报告去过急诊室(18.2%对11.6%;p = 0.003),且急诊就诊次数更多(p = 0.007),报告的初级保健就诊次数也更多(p = 0.05),以及任何住院治疗(11.2%对6.7%;p = 0.019)。
数据表明,由于AUD,医疗服务利用显著增加且可能成本高昂。急诊室和初级保健机构若投入更多资源来解决AUD问题将从中受益,这可能带来整体健康状况改善的临床益处以及降低患者和整个社会医疗成本的经济效益。