title: The use of acute and preventative medical services by a general population: relationship to alcohol consumption.
abstract: OBJECTIVE
  To investigate the hypothesis that increasing alcohol consumption is accompanied by increasing use of acute, but decreasing use of preventative, medical services among the general population.
  
  
  METHODS
  Health and life-style survey of 41,000 randomly-sampled adults in SE England who self-completed a validated questionnaire covering socio-demographics, alcohol and tobacco usage and use of acute (A&E department and general practitioner) and preventative (dental, optician, mammography and cervical cytology) services: the response rate was 60%.
  
  
  METHODS
  Comparative use of acute and preventative health care services by patients with varying consumption of alcoholic beverages. This was estimated by the odds ratio for service use, after correcting for the following confounding variables; age, social class, ethnic group, employment status, whether lives with children or with other adults, whether is a career, limiting long-term illness, depression status, smoking habit and use of private health insurance.
  
  
  RESULTS
  There was increased use of accident and emergency services by the harmful and intermediate drinking groups compared with the safe drinking group. Male abstainers attended their A&E departments more frequently than 'safe limit' drinkers. With respect to preventative services, both male and female abstainers and harmful drinkers used dental services less than safe limit drinkers. For females, mammography and cervical cytology services were less frequently used by abstainers and by harmful drinkers.
  
  
  CONCLUSIONS
  This study supports the generally held view that heavy alcohol consumers are disproportionate users of acute medical services but they are relative under-users of preventative medical care services. Alcohol abstainers are also over-users of acute services, but under-users of preventative services. These latter observations are relevant to the claims that moderate alcohol consumers have lower apparent morbidity and mortality rates compared to abstainers.
authors.affiliation: South East Institute of Public Health, Tunbridge Wells, Kent, UK.
authors.forename: P C
authors.initials: PC
authors.lastname: Cryer
authors.forename: L M
authors.initials: LM
authors.lastname: Jenkins
authors.forename: A C
authors.initials: AC
authors.lastname: Cook
authors.forename: J S
authors.initials: JS
authors.lastname: Ditchburn
authors.forename: C K
authors.initials: CK
authors.lastname: Harris
authors.forename: A R
authors.initials: AR
authors.lastname: Davis
authors.forename: T J
authors.initials: TJ
authors.lastname: Peters
mesh_terms: D017677:Age Distribution; D000428:Alcohol Drinking / Q000517:prevention & control; D000437:Alcoholism / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D018710:Pain Clinics / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D017678:Sex Distribution; D011795:Surveys and Questionnaires