title: Effects of the minimum legal drinking age on alcohol-related health service use in hospital settings in Ontario: a regression-discontinuity approach.
abstract: OBJECTIVE
  We assessed the impact of the minimum legal drinking age (MLDA) on hospital-based treatment for alcohol-related conditions or events in Ontario, Canada.
  
  
  METHODS
  We conducted regression-discontinuity analyses to examine MLDA effects with respect to diagnosed alcohol-related conditions. Data were derived from administrative records detailing inpatient and emergency department events in Ontario from April 2002 to March 2007.
  
  
  RESULTS
  Relative to youths slightly younger than the MLDA, youths just older than the MLDA exhibited increases in inpatient and emergency department events associated with alcohol-use disorders (10.8%; P = .048), assaults (7.9%; P < .001), and suicides related to alcohol (51.8%; P = .01). Among young men who had recently crossed the MLDA threshold, there was a 2.0% increase (P = .01) in hospitalizations for injuries.
  
  
  CONCLUSIONS
  Young adults gaining legal access to alcohol incur increases in hospital-based care for a range of serious alcohol-related conditions. Our regression-discontinuity approach can be used in future studies to assess the effects of the MLDA across different settings, and our estimates can be used to inform cost-benefit analyses across MLDA scenarios.
authors.affiliation: Russell C. Callaghan is with the Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia and the Dalla Lana School of Public Health, University of Toronto, Ontario. Marcos Sanches is with the Biostatistical Consulting Unit, Centre for Addiction and Mental Health, Toronto, Ontario. Jodi M. Gatley is with the Human Brain Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario and the Department of Biological Sciences, University of Toronto, Scarborough, Toronto, Ontario. James K. Cunningham is with the Department of Family and Community Medicine, University of Arizona, Tucson.
authors.forename: Russell C
authors.initials: RC
authors.lastname: Callaghan
authors.forename: Marcos
authors.initials: M
authors.lastname: Sanches
authors.forename: Jodi M
authors.initials: JM
authors.lastname: Gatley
authors.forename: James K
authors.initials: JK
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D020751:Alcohol-Induced Disorders / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D009864:Ontario; D014947:Wounds and Injuries / Q000145:classification; D055815:Young Adult