The prevalence and characteristics of alcohol-related presentations to emergency departments in rural Australia

Havard, Alys; Shakeshaft, Anthony; Conigrave, Katherine M.; Sanson‐Fisher, Rob

doi:10.1136/emj.2010.091561

Cited by 11 publications

(14 citation statements)

References 43 publications

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“…In relation to alcohol, the current study is in accordance with the findings in a recent Australian study on alcohol-related presentations to emergency departments in rural Australia where 9% of presentations were identified as alcohol related [16]. In a review of a number of studies of emergency departments, it was found that victims of violence more often were under the influence of alcohol than other patients presenting at emergency departments [17].…”

Section: Discussionsupporting

confidence: 91%

Violence- and alcohol-related acute healthcare visits in Greenland

Nexøe

Wilche

Niclasen

et al. 2012

Scand J Public Health

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Section: Discussionsupporting

confidence: 91%

Violence- and alcohol-related acute healthcare visits in Greenland

Nexøe

Wilche

Niclasen

et al. 2012

Scand J Public Health

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“…Some studies have investigated broad individual correlates of high risk alcohol use including age, gender and socio-economic status [8], yet the geographic variation in rates suggest a potential contribution of district-level factors on patterns of alcohol use. District-level factors that may characterise rural and remote communities include socio-economic disadvantage, greater rates of population change, environmental adversity, and remoteness from services/population centres [9].…”

Section: Introductionmentioning

confidence: 99%

Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia

et al. 2012

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BackgroundExcessive alcohol use is a significant problem in rural and remote Australia. The factors contributing to patterns of alcohol use have not been adequately explained, yet the geographic variation in rates suggests a potential contribution of district-level factors, such as socio-economic disadvantage, rates of population change, environmental adversity, and remoteness from services/population centres. This paper aims to investigate individual-level and district-level predictors of alcohol use in a sample of rural adults.MethodsUsing baseline survey data (N = 1,981) from the population-based Australian Rural Mental Health Study of community dwelling residents randomly selected from the Australia electoral roll, hierarchal logistic regression models were fitted for three outcomes: 1) at-risk alcohol use, indicated by Alcohol Use Disorders Identification Test scores ≥8; 2) high alcohol consumption (> 40 drinks per month); and 3) lifetime consequences of alcohol use. Predictor variables included demographic factors, pre-dispositional factors, recent difficulties and support, mental health, rural exposure and district-level contextual factors.ResultsGender, age, marital status, and personality made the largest contribution to at-risk alcohol use. Five or more adverse life events in the past 12 months were also independently associated with at-risk alcohol use (Adjusted Odds Ratio [AOR] 3.3, 99%CI 1.2, 8.9). When these individual-level factors were controlled for, at-risk alcohol use was associated with having spent a lower proportion of time living in a rural district (AOR 1.7, 99%CI 1.3, 2.9). Higher alcohol consumption per month was associated with higher district-level socio-economic ranking, indicating less disadvantage (AOR 1.2, 99%CI 1.02, 1.4). Rural exposure and district-level contextual factors were not significantly associated with lifetime consequences of alcohol use.ConclusionsAlthough recent attention has been directed towards the potential adverse health effects of district or community level adversity across rural regions, our study found relatively few district-level factors contributing to at-risk alcohol consumption after controlling for individual-level factors. Population-based prevention strategies may be most beneficial in rural areas with a higher socio-economic ranking, while individual attention should be focused towards rural residents with multiple recent adverse life events, and people who have spent less time residing in a rural area.

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“…In 2013, 26% of people aged 14 years or older consumed five or more standard drinks on a single drinking occasion at least once a month, placing them at risk of an alcohol‐related injury 2, 3. With an estimated 4–14% of emergency department (ED) presentations in Australia involving excessive alcohol consumption, depending on the time of the week, the ED remains a key setting in responding to alcohol harms 4, 5, 6. Such harms range from acute intoxication and poisoning to life‐threatening events due to intoxication (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…However, in Australia, this remains a challenge, as it is not mandatory to screen for or collect data on alcohol‐related ED presentations 4. Typically, the policy response relies on research from cross‐sectional or longitudinal survey‐based studies to estimate the prevalence of alcohol‐related ED presentations 4, 5, 7, 8. However, these study designs can be costly, are limited in their generalisability and are not timely enough to result in changes to service delivery.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

Whitlam

Dinh

Rodgers

et al. 2016

Drug and Alcohol Review

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Introduction and AimsAcute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms.Design and MethodsWe selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the ‘alcohol syndrome’) in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free‐text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an ‘acute’ or ‘chronic’ harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression.ResultsThe PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4–4.7], younger age (12–24 vs. 25–39 years: aOR = 3.4, 95% CI 2.2–5.3), not being admitted (aOR 2.2, 95% CI 1.5–3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5–2.8). PPV among 12 to 24‐year‐olds was 82%.Discussion and Conclusions The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693–701]

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The prevalence and characteristics of alcohol-related presentations to emergency departments in rural Australia

Cited by 11 publications

References 43 publications

Violence- and alcohol-related acute healthcare visits in Greenland

Violence- and alcohol-related acute healthcare visits in Greenland

Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia

Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

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