title: Health care utilization of families of carpenters with alcohol or substance abuse-related diagnoses.
abstract: BACKGROUND
  Patterns of health care utilization of families of carpenters with and without alcohol and/or substance abuse related diagnoses (ASRD) were compared.
  
  
  METHODS
  Utilization data for families of 13,657 carpenters for a 10 year period were analyzed. Concordance of diagnoses among family members was assessed and proportionate utilization ratios were used to compare the experiences of families of carpenters with and without ASRD.
  
  
  RESULTS
  Twenty-eight percent of the spouses with ASRD had a carpenter spouse with a similar diagnosis. Twenty-four percent of the families with a child with ASRD had a parent with one of these diagnoses compared to 9.4% of families without any children with ASRD (P < 0.0001). Families of carpenters with alcohol or ASRD also had different patterns of health care utilization.
  
  
  CONCLUSIONS
  Utilization patterns were influenced to a significant degree by concordant diagnoses among spouses and children. Excess mental health care was seen among families of carpenters with ASRD above their care for substance abuse treatment.
authors.affiliation: Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. hester.lipcomb@duke.edu
authors.forename: Hester J
authors.initials: HJ
authors.lastname: Lipscomb
authors.forename: John M
authors.initials: JM
authors.lastname: Dement
authors.forename: Leiming
authors.initials: L
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000191:economics; D000553:Ambulatory Care / Q000191:economics; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004651:Employment; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007750:Labor Unions; D008297:Male; D009679:Nuclear Family; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000191:economics; D014861:Washington