Characteristics of emergency department utilization among alcohol users


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

3321.0: Monday, December 12, 2005 - Board 7

Abstract #117081

Jonathon LaValley, BS, Beth Janello, and Cameron S. Crandall, MD. Department of Emergency Medicine, University of New Mexico, MSC10 5560, 1 University of New Mexico, Albuquerque, NM 87131-0001, (505)272-6183, bjanello@salud.unm.edu

We compared alcohol-only and non-alcohol-related visits from national emergency department (ED) data to measure the impact of alcohol detoxification in the ED. Using cross-sectional data from the 2002 National Hospital Ambulatory Medical Care Survey, patients with ICD9CM diagnoses for only alcohol abuse, alcohol dependency, or delirium tremens defined alcohol-only visits. These patients were compared to non-alcohol-related visits. Weighted patient and visit characteristics were compared with odds ratios (OR), t-tests and 95% confidence intervals (CI). Of 2.3 million alcohol-involved ED visits, 1.1% were for alcohol-only. Alcohol-only visits took longer (325 min vs. 188 min; p<0.0001) and patients had more diagnostic tests (4.5 vs. 3.0; p=0.09) and procedures (0.8 vs. 0.5; p<0.0001). Alcohol-only patients were more often male (72% vs. 46%; OR 3.1, CI 3.3-3.15), aged 25-44 years (48% vs. 29%; OR 2.2, CI 2.2-2.3), and urban residents (89% vs. 80%; OR 1.9, CI 1.8-2.0). The primary payer source was self-pay (42% vs. 15%; OR 4.1, CI 4.0-4.1). But, alcohol-only patients were more often admitted to a hospital (18% vs. 12%). Patients discharged from the ED were referred to alcohol treatment only 19% of the time. Only 10% of all alcohol-only visits required medical treatment beyond alcohol detoxification. ED-based medical care for the alcohol-only patient uses more resources, takes longer, and infrequently results in treatment referral. High priority should be placed on methods to identify patients who could safely be managed in sobering facilities.

Learning Objectives:

At the conclusion of the session, the learner in this session will be able to

1. Identify ED utilization characteristics among alcohol-only and non-alcohol-related visits at a national level;
2. Recognize that ED-based medical care for the alcohol-only patient is costly uses more resources, and infrequently results in patient referral to treatment;
3. Advocate for increased screening, intervention, and referral to treatment in an ED setting; and,
4. Recognize the potential benefits of non-ED-based sobering facilities.

Keywords: Alcohol, Emergency Department/Room

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Alcohol Consumption Distributions: Interventions and Policies Poster Session

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA