The 130th Annual Meeting of APHA

Abstract #47539

Constance Weisner, DrPH, MSW¹, Constance Chia, PhD², and Charles D Moore, MD, MBA². (1) KP Division of Research, Department of Psychiatry, University of California, San Francisco, 3505 Broadway Avenue, 12th floor, Oakland, CA 94611, (2) Sacramento CDRP, KP Division of Research, 2829 Watt Avenue, Suite 150, Sacramento, CA 95821

Many studies document that individuals with alcoholism and other drug problem diagnoses (AOD) have a high prevalence of coexisting medical conditions and increased medical utilization compared to control populations. It is unknown if AOD patients’ utilization of services differs from that of other patients who have identical medical conditions. We hypothesize that, for a given medical condition, the utilization of healthcare resources by AOD patients will be higher than for other patients with the same medical condition. Our previous work has demonstrated that coronary artery disease (CAD) occurs with greater frequency in AOD than in a matched control population. We analyzed the resource utilization of CAD patients contained in a care management registry that extracted clinical and administrative data on approximately 400,000 Northern California Kaiser Permanente members. The study period was January 1, 2000 to December 31, 2001. We identified a sample of 11457 adult CAD patients of which 186 also had AOD. The average numbers of visits in outpatient domains (AOD vs non-AOD) were: Emergency Room- 3.4 vs 2.4 (p=.01), Outpatient Medical- 13.4 vs 12.4 (p=.2), and Psychiatry- 6.7 vs 4.5 (p=.16). For inpatient non-psychiatric utilization during the same period (AOD vs non-AOD) we found: Percent of patients admitted- 68.7 % vs 48.1 %, Number of admissions per patient- 1.17 vs 0.94 (p=.007), and Length of stay- 3.43 vs 2.58 (p=.002)were all higher. AOD patients with CAD may benefit from service delivery configurations that foster the integration of medical and AOD treatment efforts. Care management programs targeting CAD should be encouraged to identify patients with AOD.

Learning Objectives:

• Describe three medical conditions that occur with increased frequency in patients with alcohol or other drug use disorders.
• Identify four factors that could account for increased utilization of medical services in a population of patients with coronary artery disease.
• Assess the limitations inherent in the use of data mining techniques to identify clinical subgroups of interest.

Keywords: Alcohol Problems, Heart Disease

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.