The burden of disease and the cost of illness attributable to alcohol drinking--results of a national study.
OBJECTIVE
The World Health Organization estimated that 3.2% of the burden of disease around the world is attributable to the consumption of alcohol. The aim of this study is to estimate the burden of disease attributable to alcohol consumption in Portugal.


METHODS
Burden and costs of diseases attributable to alcohol drinking were estimated based on demographic and health statistics available for 2005, using the Disability-Adjusted Life Years (DALY) lost generated by death or disability.


RESULTS
In Portugal, 3.8% of deaths are attributable to alcohol (4,059 of 107,839). After measuring the DALY generated by mortality data, the proportion of disease attributable to alcohol was 5.0%, with men having 5.6% of deaths and 6.2% of disease burden, while female figures were, respectively, 1.8 and 2.4%. Considering the sum of death and disability DALYs, liver diseases represented the main source of the burden attributable to alcohol with 31.5% of total DALYs, followed by traffic accidents (28.2%) and several types of cancer (19.2%). As for the cost of illness incurred by the health system, our results indicate that 95.1 millions euros are attributable to alcohol-related disease admissions (liver diseases, cancer, traffic accidents, and external causes) while the ambulatory costs of alcohol-related diseases were estimated in 95.9 million euros, totaling 191.0 million euros direct costs, representing 0.13% of Gross Domestic Product and 1.25% of total national health expenditures. An alternative analysis was carried out using higher consumption levels so as to replicate aggregate alcohol consumption statistics. In this case, DALYs lost increased by 11.7% and health costs by 23%.


CONCLUSIONS
Our results confirm that alcohol is an important health risk factor in Portugal and a heavy economic burden for the health system, with hepatic diseases ranking first as a source of burden of disease attributable to alcohol.
Departamento de Gastrenterologia, Unidade de Nutrição e Metabolismo, IMM, Lisbon, Portugal. hlcortezpinto@netcabo.pt
Helena
H
Cortez-Pinto
Miguel
M
Gouveia
Luís
L
dos Santos Pinheiro
João
J
Costa
Margarida
M
Borges
António
A
Vaz Carneiro
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000191:economics* / Q000453:epidemiology*; D019973:Alcohol-Related Disorders / Q000191:economics / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D055815:Young Adult