title: Impact of alcohol consumption upon medical care utilization and costs in men: 4-year observation of National Health Insurance beneficiaries in Japan.
abstract: OBJECTIVE
  The purpose of the present study was to examine the association between alcohol consumption and in-patient and out-patient care utilization and its costs, respectively.
  
  
  METHODS
  The present data were derived from a 4-year prospective observation of National Health Insurance beneficiaries in rural Japan. A total of 17 497 men aged 40-79 years were analysed, after excluding subjects who at the baseline reported having had at least one of four chronic diseases: stroke, myocardial infarction, liver disease and cancer. Alcohol intake was classified into five groups, not including ex-drinkers: life-long abstainers and ethanol intakes of 1-149 g/week, 150-299 g/week, 300-449 g/week, and > or = 450 g/week.
  
  
  RESULTS
  The hospital days and in-patient care cost showed a U-shaped relationship with alcohol consumption. In-patient cost was highest for those consuming more than 450 g/week [ pound 74.96, 95% confidence interval (CI): 54.39, 95.52] and for life-long abstainers ( pound 69.16, 95% CI: 62.08, 77.83), and lowest for those consuming 150-299 g/week ( pound 51.69, 95% CI: 45.33, 58.04). In-patient use by age specific analysis also showed a U-shape at all ages, and was lowest for those consuming 1-149 g/week in youngest age group. In contrast, the number of physician visits and out-patient cost showed an inverse linear relationships with alcohol consumption.
  
  
  CONCLUSIONS
  This study suggests that in-patient use shows a U-shaped curve and out-patient use shows an inverse linear relationship to alcohol consumption.
authors.affiliation: Research Unit for Public Health Nursing, Miyagi University School of Nursing, Miyagi, Japan. anzai@myu.ac.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Anzai
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kuriyama
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nishino
authors.forename: Kohko
authors.initials: K
authors.lastname: Takahashi
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Kaori
authors.initials: K
authors.lastname: Ohmori
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Tsubono
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000191:economics*; D000437:Alcoholism / Q000191:economics / Q000534:rehabilitation; D000553:Ambulatory Care / Q000191:economics; D017048:Health Care Costs; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires