Laia Miquel1,2,3,4, Jakob Manthey5, Jürgen Rehm6,7,8,9, Emili Vela10, Montserrat Bustins11, Lidia Segura12, Eduard Vieta13,14,15, Joan Colom12, Peter Anderson16,17, Antoni Gual18,13,14,19. 1. Grup de Recerca en addiccions Clínic, Institut Clínic de Neurosciències, Villarroel, Barcelona, Spainmiquel@clinic.cat. 2. Universitat de Barcelona, Casanova, Barcelona, Spainmiquel@clinic.cat. 3. Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer, IDIBAPS, Rosselló, Barcelona, Spainmiquel@clinic.cat. 4. Spanish network of Addictive Disorders (RTA), RETICS, Sinesio Delgado, Madrid, Spainmiquel@clinic.cat. 5. Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. 6. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada. 7. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 8. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 9. Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada. 10. Unitat d'Informació i Coneixement, Servei Català de la Salut, Travessera de les Corts, Barcelona, Spain. 11. Divisió d'Anàlisi de la Demanda i l'Activitat, Servei Català de la Salut, Travessera de les Corts, Barcelona, Spain. 12. Department of Health, Program on Substance Abuse, Public Health Agency of Catalonia, Government of Catalonia, Roc Boronat, Barcelona, Spain. 13. Universitat de Barcelona, Casanova, Barcelona, Spain. 14. Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer, IDIBAPS, Rosselló, Barcelona, Spain. 15. Hospital Clinic de Barcelona, Clinical Institute of Neuroscience, CIBERSAM, Villarroel, Barcelona, Spain. 16. Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, United Kingdom. 17. Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. 18. Grup de Recerca en addiccions Clínic, Institut Clínic de Neurosciències, Villarroel, Barcelona, Spain. 19. Spanish network of Addictive Disorders (RTA), RETICS, Sinesio Delgado, Madrid, Spain.
Abstract
OBJECTIVE: To examine health services use on the basis of alcohol consumption. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
OBJECTIVE: To examine health services use on the basis of alcohol consumption. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: James M Bolton; Christine Leong; Okechukwu Ekuma; Heather J Prior; Geoffrey Konrad; Jennifer Enns; Deepa Singal; Josh Nepon; Michael T Paillé; Greg Finlayson; Nathan C Nickel Journal: CMAJ Open Date: 2020-11-24
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