Medicine Service, VA Medical Center, 510, 20th Street South, FOT 805B, Birmingham, AL 35233, USA; Department of Medicine at School of Medicine, USA; Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, 1720 Second Ave South, Birmingham, AL 35294-0022, USA.
Drug Alcohol Depend. 2021 May 1;222:108653. doi: 10.1016/j.drugalcdep.2021.108653. Epub 2021 Feb 26.
To examine the outcomes of alcohol use disorder (AUD)-hospitalizations.
We used the U.S. National Inpatient Sample (NIS) data from 1998 to 2016 to examine predictors of Healthcare utilization (total hospital charges, discharge destination, length of hospital stay) and in-hospital mortality for AUD-hospitalization outcomes. We used logistic regression to assess the association of patient demographics (age, sex, race/ethnicity, household income), comorbidity (Deyo-Charlson index), insurance payer (Medicare, Medicaid, private, self-pay or other), and hospital characteristics (location/teaching status; hospital bed size; and region) with outcomes RESULTS: There were 5,590,952 primary AUD-hospitalizations from 1998 to 2016; of these 106,419 (1.9 %) died in-hospital. The mean age was 48 years, 73 % were male, 59 % white, and 57 % had a Deyo-Charlson comorbidity score of zero. In multivariable-adjusted analyses of AUD-hospitalizations, older age, female sex, higher Deyo-Charlson index, rural location or hospitals with medium or large bed sizes were associated with significantly higher in-hospital mortality and healthcare utilization. Similarly, South or Western U.S. hospital location, White race, or high income quartile were associated with higher healthcare utilization. Compared to a private insurance payer, Medicare or Medicaid insurance payers were associated with higher healthcare utilization, but lower in-hospital mortality.
We identified several independent associations of modifiable and non-modifiable factors with healthcare utilization and mortality outcomes for AUD-hospitalizations. These findings provide an opportunity for prognosis, resource allocation and the development of interventions to improve outcomes of AUD-hospitalizations in the future.
探讨酒精使用障碍（AUD）-住院患者的结局。
我们使用美国 1998 年至 2016 年国家住院患者样本（NIS）数据，考察医疗保健利用（总住院费用、出院去向、住院时间）和 AUD 住院结局的院内死亡率的预测因素。我们使用逻辑回归评估患者人口统计学特征（年龄、性别、种族/民族、家庭收入）、合并症（Deyo-Charlson 指数）、保险支付者（医疗保险、医疗补助、私人、自付或其他）和医院特征（地理位置/教学地位；医院床位数；和地区）与结局的关系。
1998 年至 2016 年共发生 5590952 例原发性 AUD 住院患者，其中 106419 例（1.9%）院内死亡。患者平均年龄为 48 岁，73%为男性，59%为白人，57%的患者 Deyo-Charlson 合并症评分为 0。在 AUD 住院患者的多变量调整分析中，年龄较大、女性、Deyo-Charlson 指数较高、农村地区或中等或大型床位数的医院与院内死亡率和医疗保健利用显著增加相关。同样，美国南部或西部的医院位置、白人种族或高收入四分位数与更高的医疗保健利用率相关。与私人保险支付者相比，医疗保险或医疗补助保险支付者与更高的医疗保健利用率相关，但院内死亡率较低。
我们确定了与 AUD 住院患者医疗保健利用率和死亡率结局相关的几个可改变和不可改变因素的独立关联。这些发现为未来预后、资源分配和制定干预措施以改善 AUD 住院患者的结局提供了机会。
