title: The Association Between Unhealthy Alcohol Use and Acute Care Expenditures in the 30 Days Following Hospital Discharge Among Older Veterans Affairs Patients with a Medical Condition.
abstract: Hospital readmissions and emergency department (ED) visits within 30 days of discharge are costly. Heavy alcohol use could predict increased risk for post-discharge acute care. This study assessed 30-day acute care utilization and expenditures for different categories of alcohol use. Veterans Affairs (VA) patients age ≥65 years with past-year alcohol screening, hospitalized for a medical condition, were included. VA and Medicare health care utilization data were used. Two-part models adjusted for patient demographics. Among 416,050 hospitalized patients, 25% had 30-day acute care use. Nondrinking patients (n = 267,746) had increased probability of acute care use, mean utilization days, and expenditures (difference of $345; 95% CI $268-$423), relative to low-risk drinkers (n = 105,023). High-risk drinking patients (n = 5,300) had increased probability of acute care use and mean utilization days, but not expenditures. Although these patients did not have greater acute care expenditures than low-risk drinking patients, they may nevertheless be vulnerable to poor post-discharge outcomes.
authors: Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA. ljchavez@uw.edu.|Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA. ljchavez@uw.edu.
authors: Laura J
authors: LJ
authors: Chavez
authors: Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.|Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
authors: Chuan-Fen
authors: CF
authors: Liu
authors: Bates College, 2 Andrews Rd, Lewiston, ME, 04240, USA.
authors: Nathan
authors: N
authors: Tefft
authors: Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.|Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
authors: Paul L
authors: PL
authors: Hebert
authors: Department of Pharmacy, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
authors: Beth
authors: B
authors: Devine
authors: Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.|Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.|Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.|Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.|Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.
authors: Katharine A
authors: KA
authors: Bradley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000191:economics*; D000437:Alcoholism / Q000175:diagnosis / Q000191:economics; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare; D010359:Patient Readmission / Q000191:economics; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Alcohol Screening; Emergency Department Visit; Index Hospitalization; Unplanned Readmission; Veteran Affair