The burden of alcohol misuse on an inner‐city general hospital

Abstract

Alcohol consumption in the UK has been increasing steadily. We prospectively studied the burden on hospital services caused by overt alcohol misuse, in an inner-city hospital in north-west England. All Accident & Emergency (A&E) patients were assessed to determine whether their hospital attendance was alcohol-related, and whether this resulted in admission and/or generated new out-patient appointments. Over 2 months, 1915 patients attended A&E with alcohol-related problems, accounting for 12% of attendances; 50% were aged 18-39 years, and acute alcohol intoxication was the commonest presenting complaint. Overall, 6.2% of all hospital admissions were due to alcohol-related problems. Over 2800 new out-patient visits were likely to have been generated over an 18-month period from initial attendance with an alcohol-related problem, mostly for orthopaedic clinics. The burden placed by overt alcohol-related problems on hospitals is enormous, both in terms of the emergency and out-patient services. The implementation of education, screening and intervention strategies in A&E departments, and employment of key trained personnel, should be considered, to optimize the clinical management of these patients.

The Impact of Psychiatric Diagnosis on Length of Stay in a University Medical Center in the Managed Care Era

“…Prospective studies using various methods have reported a rate of substance use comorbidity of between 8% and 30% in medical patients. 6,9,26,27,29,30 Thus, our rate of substance use disorders, although not derived in a prospective fashion with validated instruments, is consistent with prior reports.…”

Attitudes and beliefs of emergency department staff regarding alcohol-related presentations

“…Studies have estimated that between 2% and 40% of ED presentations are either alcohol-related or have evidence of a coincident alcohol problem (Charalambous, 2002). These presentations are more likely to occur out of hours and on weekends (Pirmohamed et al, 2000), when fewer staff and resources are available. They are also more likely to display violence and aggression towards staff (Crilly et al, 2004;Jenkins et al, 1998) and to be admitted to hospital (O'Farrell et al, 2004).…”

Using administrative health data for the surveillance of interventions for alcohol-related harm among young people

“…Longitudinal studies, such as the National Alcohol Indicators Project in Australia, 5 have focused on data concerning admissions to hospital, which is a limitation considering that most alcohol-related conditions do not result in that outcome. 6,7 Sources of information on the effect of interventions include health surveys and administrative data, as well as information from police and criminal justice databases (Appendix 1, available at www .cmaj .ca /cgi /content /full /cmaj .110367 /DC1). 8 Administrative data include data on ambulance use or presentations to hospital.…”