Royal College of Surgeons in Ireland, Dublin, Ireland.
Hepatology Unit, Beaumont Hospital, Dublin, Ireland.
BMJ Open. 2023 Feb 3;13(2):e065220. doi: 10.1136/bmjopen-2022-065220.
To determine the impact of minimum unit pricing (MUP) on the primary outcome of alcohol-related hospitalisation, and secondary outcomes of length of stay, hospital mortality and alcohol-related liver disease in hospital.
Databases MEDLINE, Embase, Scopus, APA Psycinfo, CINAHL Plus and Cochrane Reviews were searched from 1 January 2011 to 11 November 2022. Inclusion criteria were studies evaluating the impact of minimum pricing policies, and we excluded non-minimum pricing policies or studies without alcohol-related hospital outcomes. The Effective Public Health Practice Project tool was used to assess risk of bias, and the Bradford Hill Criteria were used to infer causality for outcome measures.
MUP sets a legally required floor price per unit of alcohol and is estimated to reduce alcohol-attributable healthcare burden.
All studies meeting inclusion criteria from any country INTERVENTION: Minimum pricing policy of alcohol PRIMARY AND SECONDARY OUTCOME MEASURES: RESULTS: 22 studies met inclusion criteria; 6 natural experiments and 16 modelling studies. Countries included Australia, Canada, England, Northern Ireland, Ireland, Scotland, South Africa and Wales. Modelling studies estimated that MUP could reduce alcohol-related admissions by 3%-10% annually and the majority of real-world studies demonstrated that acute alcohol-related admissions responded immediately and reduced by 2%-9%, and chronic alcohol-related admissions lagged by 2-3 years and reduced by 4%-9% annually. Minimum pricing could target the heaviest consumers from the most deprived groups who tend to be at greatest risk of alcohol harms, and in so doing has the potential to reduce health inequalities. Using the Bradford Hill Criteria, we inferred a 'moderate-to-strong' causal link that MUP could reduce alcohol-related hospitalisation.
Natural studies were consistent with minimum pricing modelling studies and showed that this policy could reduce alcohol-related hospitalisation and health inequalities.
CRD42021274023.
确定最低单位定价（MUP）对与酒精相关的住院治疗的主要结果以及住院时间、医院死亡率和酒精性肝病的次要结果的影响。
从 2011 年 1 月 1 日至 2022 年 11 月 11 日，检索了 MEDLINE、Embase、Scopus、APA Psycinfo、CINAHL Plus 和 Cochrane Reviews 数据库。纳入标准为评估最低定价政策影响的研究，我们排除了非最低定价政策或无酒精相关住院结果的研究。使用有效公共卫生实践项目工具评估偏倚风险，并使用布拉德福德希尔标准推断结果测量的因果关系。
MUP 设定了法定的每单位酒精最低价格，据估计可以减轻与酒精相关的医疗保健负担。
来自任何国家的符合纳入标准的所有研究
酒精最低定价政策
结果：有 22 项研究符合纳入标准；6 项自然实验和 16 项模型研究。包括澳大利亚、加拿大、英格兰、北爱尔兰、爱尔兰、苏格兰、南非和威尔士。模型研究估计，MUP 每年可减少 3%-10%的与酒精相关的入院率，而大多数真实世界的研究表明，急性酒精相关入院率立即响应并减少了 2%-9%，慢性酒精相关入院率滞后 2-3 年并每年减少 4%-9%。最低定价可以针对来自最贫困群体的最重消费者，这些消费者往往面临最大的酒精危害风险，因此有可能减少健康不平等。使用布拉德福德希尔标准，我们推断出 MUP 可以减少与酒精相关的住院治疗，这是一个“中度到强”的因果关系。
自然研究与最低定价模型研究一致，表明该政策可以减少与酒精相关的住院治疗和健康不平等。
CRD42021274023。
