Alcohol consumption and utilization of health services in a health maintenance organization.
OBJECTIVE
This study examined the relation between alcohol use and utilization of health services during a 3-year period in a sample of 4,264 adult respondents to a member health survey in a health maintenance organization.


METHODS
Respondents were categorized as abstainers (no drinks in the past year, n = 1,139), lighter drinkers (less than seven drinks/week, n = 2,330), moderate drinkers (seven to 13 drinks/week, n = 498), and heavier drinkers (> or =14 drinks/week, n = 297). Each drinker group was compared with abstainers on outpatient visits, hospital days, and number of hospitalizations controlling for age, race, and health plan membership.


RESULTS
The mean number of outpatient visits was inversely related to the amount of alcohol consumed. Significant differences also were found for mean number of hospitalizations and mean days hospitalized per year. Compared with the three drinker groups, abstainers were significantly higher on both inpatient measures.


CONCLUSIONS
These results might be explained by the inclusion in the abstainer group of exdrinkers who quit because of illness, inattention to health problems by heavier drinkers, or lower rates of illness among drinkers. The findings underscore the importance of replicating our study in other cohorts in which problem drinkers can be identified and compared with non-problem drinkers and in which lifelong abstainers can be separated from exdrinkers in the analysis.
Armstrong
M A
MA
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611, USA. maa@dor.kaiser.org
Midanik
L T
LT
Klatsky
A L
AL
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D014600:Utilization Review