title: The prevalence and characteristics of alcohol-related presentations to emergency departments in rural Australia.
abstract: BACKGROUND
  The burden of harm associated with alcohol misuse is disproportionately high in rural areas of Australia, and a considerable proportion of this burden is borne by the health system. The health impact of alcohol in rural areas has been measured in terms of the contribution of alcohol to hospital inpatient admissions and mortality rates, despite many more alcohol-related cases presenting to emergency departments (EDs). This study aims to estimate the proportion of presentations to EDs in rural Australia that are alcohol-related and to identify the associated patient and presentation characteristics.
  
  
  METHODS
  Patients aged ≥14 years presenting to four EDs in rural NSW were assessed on two measures: (1) Clinician judgement of alcohol consumption, and (2) patient self-report of alcohol consumption in the 6 h preceding the onset of their condition.
  
  
  RESULTS
  Preliminary analyses revealed sample selection biases in two of the EDs, and these samples were consequently excluded from further analyses. In the two remaining EDs, 46% of presentations were assessed, of which 9% were identified as alcohol-related. Presentations for mental disorders, those with more urgent triage categories and those occurring on weekends or at night were more often alcohol-related.
  
  
  CONCLUSIONS
  The prevalence of alcohol-related ED presentations observed was at the lower end of the documented range, probably due to methodological differences and limitations, as well as geographic variation. Despite this, alcohol-related presentations were associated with a substantial impact on the ED. Policies and programs to reduce the impact of alcohol on rural emergency departments are needed.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney 2052, Australia. a.havard@unsw.edu.au
authors.forename: A
authors.initials: A
authors.lastname: Havard
authors.forename: A P
authors.initials: AP
authors.lastname: Shakeshaft
authors.forename: K M
authors.initials: KM
authors.lastname: Conigrave
authors.forename: R W
authors.initials: RW
authors.lastname: Sanson-Fisher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population