Direct cost of alcohol‐related presentations to Royal Perth Hospital emergency department

Lingamanaicker, Kausalya; Geelhoed, Elizabeth; Fatovich, Daniel M

doi:10.1111/1742-6723.13307

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…All presentations There were 21,715 ED presentations incurred by the 2,519 patients with alcohol use disorders. Among these presentations, 63.2% (13,724) were incurred by the patients who did not have interactions with the community-based D&A services (Table 2). Those who did not have interactions were more likely to present with abdominal pain (36.5% vs 21.5%, p < 0.001) and chest pain (15.9% vs 12.0%, p < 0.001) than their counterparts.…”

Section: Characteristics Of the Ed Presentationsmentioning

confidence: 99%

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Emergency Department Presentations of Patients with Alcohol use Disorders in an Australian Regional Health District

Zhang

Qian

et al. 2022

Substance Abuse

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Background: This study aimed to investigate the longitudinal changes in emergency department (ED) presentations incurred by patients with alcohol use disorders. Methods: A retrospective quantitative analysis was conducted on patients' ED presentations between December 2011 and January 2019 in an Australian regional health district. The health district has five EDs serving rural, regional, and metropolitan areas. Patients with alcohol use disorders were divided into two groups for comparison: those who had interactions with the community-based Drug and Alcohol (D&A) services and those who did not. Results: A total of 2,519 individual patients with alcohol use disorders made 21,715 ED presentations. Among these patients, 75.4% did not have interactions with the community-based D&A services. Compared with those who had, these patients were older, more likely to be diagnosed with abdominal pain (26.9% vs 12.0%, p < 0.001) and chest pain (16.2% vs 8.6%, p < 0.001), and had longer mean length of ED stay (7 hours and 41.7 minutes vs 6 hours and 25.6 minutes, p < 0.001). For the patients who had interactions with the communitybased D&A services, their 28-day re-presentation rates decreased from 55. 5% (2013-14) to 45.1% (2017-18); however, were higher than that of those who had no interactions (41.1% to 32.8%). Overall, 21.9%À24.5% of the patients were frequent ED presenters (i.e., !4 visits per year). Frequent ED presenters were proportionately higher among the patients who had interactions with the community-based D&A services, consistently over the relevant years. Although patients with alcohol use disorders frequently presented to EDs, their alcohol use disorders were only identified in 8.9% of their presentations. Conclusions: Patients with alcohol use disorders were often unidentified in EDs. Those who did not have interactions with the community-based D&A services were less likely to be diagnosed with alcohol use disorders when presenting to EDs.

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Section: Characteristics Of the Ed Presentationsmentioning

confidence: 99%

“…It is estimated that 37% of all ED re-presentations are preventable 10 . Alcohol-related ED presentations are a major public health burden, costing 7.5 million Australian dollars in 2014 according to the Royal Perth Hospital's cost estimation 13 …”

Section: Introductionmentioning

confidence: 99%

Emergency Department Presentations of Patients with Alcohol use Disorders in an Australian Regional Health District

Zhang

Qian

et al. 2022

Substance Abuse

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“…Accurate measurement of ARH is crucial for developing effective public health strategies. Unfortunately, EDs, despite being at the forefront of ARH management, face challenges in capturing comprehensive ARH data 7,9,10 . Current collection methods are inadequate, and Australian EDs are not obligated to screen or collect alcohol‐related presentation data.…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately, EDs, despite being at the forefront of ARH management, face challenges in capturing comprehensive ARH data. 7 , 9 , 10 Current collection methods are inadequate, and Australian EDs are not obligated to screen or collect alcohol‐related presentation data. As a result, alternative measures, such as using time of presentation, have been developed to estimate ARH.…”

Section: Introductionmentioning

confidence: 99%

Assessing the utility of night‐time presentations as a proxy for alcohol‐related harm among young emergency department trauma patients

Sims

Pereira

Fatovich

et al. 2023

Emerg Medicine Australasia

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ObjectiveTo assess the usefulness of night‐time presentations to measure alcohol‐related harm (ARH) in young trauma patients, aged 12–24 years, attending Western Australian EDs.MethodsA retrospective longitudinal study examined alcohol‐related ED presentations in Western Australia (WA; 2002–2016) among 12‐ to 24‐year‐olds. Data from the Emergency Department Data Collection, WA State Trauma Registry Database and Hospital Morbidity Data Collection were used to identify ARH through specific codes and text searches. These were compared to ARH estimates based on presentation time. Statistical analysis involved sensitivity and specificity calculations and Cox proportional hazards modelling.ResultsWe identified 2644 (17.8%) night‐time presentations as a proxy measure of ARH among the 14 887 presentations of patients aged 12–24 years. This closely matched the 3064 (20.6%) identified as ARH through coding methods. The highest risk for an ARH presentation occurred during the night hours between 00.00 and 04.59 hours. During these hours, the risk was 4.4–5.1 times higher compared to presentations at midday (between 12.00 and 12.59 hours). However, when looking at individual patients, we observed that night‐time presentations were not a strong predictor of ARH (sensitivity: 0.39; positive predictive value: 0.46).ConclusionsImplementing targeted interventions during night hours could be beneficial in addressing ARH presentations. However, relying solely on the time of presentation as a proxy for ARH is unlikely to effectively identify ARH in young individuals. Instead, the present study emphasises the importance of implementing mandatory data collection strategies in EDs to ensure accurate measurement of ARH cases.

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“…Alcohol-related harm (ARH) remains one of the leading causes of preventable hospitalisations that continue to place a large burden on hospital resources [1]. The reduction of preventable visits is an opportunity to improve quality of care and reduce health-care spending [2], but little research has been conducted on repeat ARH.…”

Section: Introductionmentioning

confidence: 99%

Young people with prior health service contacts have increased risk of repeated alcohol‐related harm hospitalisations

Sims

Pereira

Preen

et al. 2022

Drug and Alcohol Review

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Introduction After a first alcohol‐related hospitalisation in youth, subsequent hospitalisations may demonstrate an increased risk of further alcohol‐related hospitalisations, but there is no existing data on this. Methods A retrospective longitudinal study between July 1992 and June 2017 using linked hospital administrative data identified 23 464 Western Australian young people [9009 (38.4%) females and 14 455 (61.6%) males], aged 12–24 years hospitalised for at least one alcohol‐related harm (ARH) episode of care. Cox regression was used to estimate hazard ratios (HR) between risk factors and repeated alcohol‐related hospitalisation after the first discharge for ARH. Results Of those admitted for an alcohol‐related hospitalisation (n = 23 464), 21% (n = 4996) were readmitted for ARH. This high‐risk sub‐group comprised 46% (n = 16 017) of the total alcohol‐related admissions (n = 34 485). After the first discharge for ARH, 16% (804) of people who experienced an alcohol‐related readmission were readmitted within 1 month, and 51.8% (2589) were readmitted within 12 months. At increased risk of readmission were Aboriginal people and those with prior health service contacts occurring before their first alcohol‐related hospitalisation, including illicit drug hospitalisations, mental health contacts and, in a sub‐analysis, emergency department presentations. Discussion and Conclusions The probability of a repeated ARH hospitalisation was highest in the first month after initial discharge. There is a high‐risk sub‐group of young people more likely to have a repeat ARH hospitalisation. This represents an opportunity to provide interventions to those most at risk of repeated ARH.

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Direct cost of alcohol‐related presentations to Royal Perth Hospital emergency department

Cited by 6 publications

References 13 publications

Emergency Department Presentations of Patients with Alcohol use Disorders in an Australian Regional Health District

Emergency Department Presentations of Patients with Alcohol use Disorders in an Australian Regional Health District

Assessing the utility of night‐time presentations as a proxy for alcohol‐related harm among young emergency department trauma patients

Young people with prior health service contacts have increased risk of repeated alcohol‐related harm hospitalisations

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