Armstrong M A, Midanik L T, Klatsky A L
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611, USA.
Med Care. 1998 Nov;36(11):1599-605. doi: 10.1097/00005650-199811000-00009.
This study examined the relation between alcohol use and utilization of health services during a 3-year period in a sample of 4,264 adult respondents to a member health survey in a health maintenance organization.
Respondents were categorized as abstainers (no drinks in the past year, n = 1,139), lighter drinkers (less than seven drinks/week, n = 2,330), moderate drinkers (seven to 13 drinks/week, n = 498), and heavier drinkers (> or =14 drinks/week, n = 297). Each drinker group was compared with abstainers on outpatient visits, hospital days, and number of hospitalizations controlling for age, race, and health plan membership.
The mean number of outpatient visits was inversely related to the amount of alcohol consumed. Significant differences also were found for mean number of hospitalizations and mean days hospitalized per year. Compared with the three drinker groups, abstainers were significantly higher on both inpatient measures.
These results might be explained by the inclusion in the abstainer group of exdrinkers who quit because of illness, inattention to health problems by heavier drinkers, or lower rates of illness among drinkers. The findings underscore the importance of replicating our study in other cohorts in which problem drinkers can be identified and compared with non-problem drinkers and in which lifelong abstainers can be separated from exdrinkers in the analysis.
本研究在一个健康维护组织中，对4264名成年受访者进行的会员健康调查样本中，考察了三年期间饮酒与医疗服务利用之间的关系。
受访者被分为戒酒者（过去一年不饮酒，n = 1139）、轻度饮酒者（每周饮酒少于7杯，n = 2330）、中度饮酒者（每周饮酒7至13杯，n = 498）和重度饮酒者（每周饮酒≥14杯，n = 297）。在控制年龄、种族和健康计划会员资格的情况下，将每个饮酒者组与戒酒者在门诊就诊次数、住院天数和住院次数方面进行比较。
门诊就诊的平均次数与饮酒量呈负相关。每年的住院平均次数和平均住院天数也存在显著差异。与三个饮酒者组相比，戒酒者在这两项住院指标上均显著更高。
这些结果可能的解释是，戒酒者组中包括因疾病而戒酒的人、重度饮酒者对健康问题的忽视，或饮酒者中较低的患病率。研究结果强调了在其他队列中重复我们研究的重要性，在这些队列中可以识别出问题饮酒者并与非问题饮酒者进行比较，并且在分析中可以将终身戒酒者与戒酒者区分开来。
