Grup de Recerca en addiccions Clínic, Institut Clínic de Neurosciències, Villarroel, Barcelona,
Universitat de Barcelona, Casanova, Barcelona,
Eur Addict Res. 2018;24(5):234-244. doi: 10.1159/000493884. Epub 2018 Oct 3.
To examine health services use on the basis of alcohol consumption.
A cross-sectional study was carried out on patients visiting the Primary Health Care (PHC) settings in Catalonia during 2011 and 2012; these patients had a history of alcohol consumption. Information about outpatient visits in the PHC setting, hospitalizations, specialists' visits and emergency room visits for the year 2013 was obtained from 2 databases (the Information System for the Development of Research in PHC and the Catalan Health Surveillance System). Risky drinkers were defined as those who consumed more than 280 g per week for men or more than 170 g per week for women, or any amount of alcohol while being involved in a high risk work activity, or taking medication that significantly interferes with alcohol or when being pregnant. Binge drinkers (> 60 g in men or > 50 g in women in a short amount of time more than once a month) were also considered risky drinkers.
A total of 606,948 patients reported consuming alcohol (of which 10.5% were risky drinkers). Risky drinkers were more likely to be admitted to hospitals or emergency departments (range of ORs 1.08-1.18) compared to light drinkers. Male risky drinkers used fewer PHC services than male light drinkers (OR 0.89, 95% CI 0.87-0.92). In general, risky alcohol users used services more and had longer hospital stays. When stratifying by socioeconomic level of the residential area, we found that risky drinking failed significance, while current or past cigarette smoking was associated with higher healthcare use.
Risky drinkers use more expensive services, such as hospitals and emergency rooms, but not PHC services, which may suggest that prevention strategies and alcohol interventions should also be implemented in those settings.
基于饮酒情况考察卫生服务利用度。
2011 年至 2012 年期间，对在加泰罗尼亚基层医疗保健（PHC）就诊且有饮酒史的患者进行了一项横断面研究。从两个数据库（基层医疗保健研究开发信息系统和加泰罗尼亚卫生监测系统）获取了 2013 年门诊就诊、住院、专科就诊和急诊就诊信息。将每周饮酒量男性超过 280 克、女性超过 170 克，或在高风险工作活动中饮酒、服用明显干扰酒精代谢的药物或怀孕的情况下饮酒，或每月至少一次狂饮（男性超过 60 克、女性超过 50 克）定义为危险饮酒者。也将狂饮者视为危险饮酒者。
共有 606948 名患者报告饮酒（其中 10.5%为危险饮酒者）。与轻度饮酒者相比，危险饮酒者更有可能住院或到急诊就诊（比值比范围为 1.08-1.18）。与轻度饮酒者相比，男性危险饮酒者使用的 PHC 服务较少（比值比 0.89，95%可信区间 0.87-0.92）。一般来说，危险饮酒者使用的服务更多，住院时间更长。在按居住地区的社会经济水平进行分层时，我们发现危险饮酒与更高的医疗保健利用度之间的关联无统计学意义，而当前或过去的吸烟则与更高的医疗保健利用度相关。
危险饮酒者使用更昂贵的服务，如医院和急诊室，但不使用 PHC 服务，这可能表明应在这些环境中实施预防策略和酒精干预措施。
