Impact of alcohol policy changes on substance‐affected patients attending an emergency department in the Northern Territory with police

Abstract

Objective Assess the impact of Northern Territory alcohol policy changes to ED utilisation at Royal Darwin‐Palmerston Regional Hospitals. Methods Interrupted time series analysis explored trends in monthly ED attendance numbers and the proportion self‐discharging prior to policy changes (September 2016 to August 2017) and after three sequential interventions; the Banned Drinker Register, introduced September 2017, system changes to the sobering shelter, January 2018, and the minimum unit floor price (MUFP), October 2018. A targeted cohort of attendances transported by police as an alternative to the sobering shelter or police watch‐house when there is a medical concern was selected as they are likely impacted by all policy changes. Results Police transported 1176 patients on 2070 occasions from September 2016 to March 2019. There was a downward trend in monthly attendances across the study period, with no significant change attributable to the Banned Drinker Register, a significant step decrease with the sobering shelter changes (P = 0.002), and a significant gradual decrease following the MUFP (P = 0.025). This represented an immediate decrease of 3.82 attendances per month/10 000 residents following the sobering shelter changes and a gradual decrease of 0.92 attendances/10 000 residents after the MUFP. Rates of self‐discharge were high, 45% in the pre‐intervention phase, decreasing to 28% following the MUFP but this trend did not reach significance with any intervention. Conclusion The sequential introduction of broad sweeping alcohol policy changes introduced by the Northern Territory government was associated with significant reductions in ED utilisation. The proximity of the introduction of interventions creates difficulties identifying individual policy influence.

Disentangling the messiness of natural experiments to evaluate public policy

“…Further support comes from the experience of other countries that have implemented and evaluated MUP. In the Northern Territory in Australia, for example, MUP was found to be associated with reduced consumption and improvements among a range of short‐term health and social outcomes, including reduced alcohol consumption in targeted products [4, 5], reduced alcohol‐related assaults [6] and reduced police escorted emergency department attendances [7]. The concern that MUP would unfairly affect those who drink at low to moderate levels (i.e.…”

The minimum unit price of alcohol should be indexed for inflation: Lessons from Scotland and Australia

“…in alcohol consumption and related health harms have been seen throughout the population in Scotland [3,5,6] and the Northern Territory (NT) of Australia [1,7,8].…”