The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64518

Barbara J. Kilbourne, PhD¹, Baqar, A Husaini, PhD¹, Darren E. Sherkat, PhD², Robert S. Levine, MD³, and Van A. Cain, MA¹. (1) Center for Health Research, Tennessee State University, 3500 John A. Merritt Blvd., Nashville, TN 37209, (2) Department of Sociology, Southern Illinois University at Carbondale, 13 Hillcrest Drive, Carbondale, IL 62901, (3) Preventive Medicine, Meharry Medical College, 1005 DB Todd Blvd, Nashville, TN 37208

Purpose: We assess patterns of alcohol disorders among the Tennessee Medicare elderly, comparing the prevalence between African Americans and Whites, and women and men within each race, Based on these patterns we demonstrate the effects of alcohol disorders on the utilization of outpatient physician services. Method: In order to study service utilization of patients with alcohol disorders, we using billing information from 51,643 Whites and 61,178 African Americans who comprised a 10% sample of White and a 100% sample of African American Medicare Part B beneficiaries in Tennessee in 1996 Our analysis codes patients diagnosed with ICD-9 codes: 303, 305.0, or 291, as alcohol disordered. Covariates include: gender, age, rural or urban residence and medical co-morbidity. We use binary logistic and linear regression analyses to examine how alcohol disorders affect the number of physician visits and costs associated with those visits. Results: Overall, there were 5.45 per 1000 individuals with alcohol disorders. Prevalence was twice as high for African Americans, independent of gender. However, within race groups women were 70% less likely to be classified as having an alcohol disorder (p<0.001). Elders diagnosed with alcohol disorders visited physicians twice as often as elders without alcohol disorders (p<0.001), resulting in Medicare reimbursements for physicians visits, on average $1000 more per individual with an alcohol disorder (p<0.001). Even accounting for under diagnosis, racial bias, and other limitations, our analyses reveal that alcohol disorders significantly increases the cost of outpatient physician services. This supports the importance of early identification, intervention and treatment.

Learning Objectives:

• We assess differences in patterns of alcohol disorders between African American and White beneficiaries of Meidicare Part B, and document the costs for physician outpatient services attributable to alcohol disorders.

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.