title: Alcohol use increases diagnostic testing, procedures, charges, and the risk of hospital admission: a population-based study of injured patients in the emergency department.
abstract: BACKGROUND
  Alcohol use may alter mental status and vital signs in injured patients, leading to increased testing during emergency department (ED) evaluation. We hypothesized that alcohol use increases the hospital charges when caring for these injured patients.
  
  
  METHODS
  The National Hospital Ambulatory Medical Care Survey collects weighted population-based estimates of ED use. We analyzed injury-related visits of adult patients, and resource use and admission rates were compared by the presence of alcohol.
  
  
  RESULTS
  Alcohol was involved in 6.0% of injury-related ED visits. Alcohol-present patients arrived by ambulance more frequently (45% vs 21%, P < .001), had a 26% longer ED stay (211 vs 167 minutes, P < .001), and underwent more diagnostic testing. They were twice as likely to be admitted (14.0% vs 6.5%, P < .001). Additional ED charges were over $217 million.
  
  
  CONCLUSIONS
  Patients with alcohol-related injuries use significantly more resources, with a significant added financial burden. Insurance companies in many states can deny coverage for injuries caused by alcohol use, shifting these expenses to trauma centers.
authors.affiliation: Division of Trauma, Critical Care, Burns and Emergency Surgery, University of Arizona, 1501 North Campbell Avenue, Room 5411D, Tucson, AZ, USA. tokeeffe@surgery.arizona.edu
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
authors.forename: Shahid
authors.initials: S
authors.lastname: Shafi
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Larry M
authors.initials: LM
authors.lastname: Gentilello
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data*; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States; D014947:Wounds and Injuries / Q000097:blood / Q000175:diagnosis*
chemical_list: D015415:Biomarkers