Alcohol Consumption and Inpatient Health Service Utilization in a Cohort of Patients With Alcohol Dependence After 20 Years of Follow-up.
To examine the association between drinking levels and inpatient health service utilization in people with a lifetime diagnosis of alcohol dependence.



A longitudinal prospective study was conducted in a cohort of patients with alcohol dependence who had undergone treatment in 1987. Current results refer to the association between drinking patterns at 20-year follow-up and subsequent inpatient health service utilization. At 20 years after baseline, 530 of 850 patients were alive with administrative data available. Follow-up interview was conducted on 378 patients. There were 88 refusals and 64 could not be traced. Three categories of alcohol consumption were established (abstainers, moderate drinkers and heavy drinkers) depending on the pattern of alcohol use during the last year prior to the evaluation. Health service utilization was based on official statistics, including admissions to general, rehabilitation and psychiatric hospitals. The time period analysed was 5 years after the assessment of drinking patterns.



Admission rates were lowest for abstainers compared to people with moderate and heavy drinking. With respect to hospital days, heavy drinking was associated with significantly higher adjusted rates than both abstainers and moderate drinkers. Alcohol-related diagnoses in hospital admissions were more frequent for both moderate and heavy drinkers.



Abstinence and moderate alcohol consumption were both associated with lower hospitalization in people with a lifetime diagnosis of alcohol dependence. Thus, not only abstinence-oriented treatment strategies but also those to reduce alcohol intake would reduce inpatient hospitalizations.



Abstention and reduced drinking in lifetime alcohol-dependent patients were associated with lower health care utilization compared to heavy drinking. Alcohol treatment strategies for alcohol-dependent patients have a positive impact on the reduction in health care utilization. An increase in treatment rate for alcohol use disorders will consequently have marked population health improvements.
Grup de Recerca en Addiccions Clínic, Institut Clínic de Neurosciències, Universitat de Barcelona, Villarroel, 170, 08036 Barcelona, Spain.|Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer, IDIBAPS, Rosselló, 149-153, 08036 Barcelona, Spain.|Spanish Network of Addictive Disorders (RTA). RETICS, Sinesio Delgado, 4, 28029 Madrid, Spain.
Laia
L
Miquel
Grup de Recerca en Addiccions Clínic, Institut Clínic de Neurosciències, Universitat de Barcelona, Villarroel, 170, 08036 Barcelona, Spain.|Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer, IDIBAPS, Rosselló, 149-153, 08036 Barcelona, Spain.|Spanish Network of Addictive Disorders (RTA). RETICS, Sinesio Delgado, 4, 28029 Madrid, Spain.
Antoni
A
Gual
Divisió d'Anàlisi de la Demanda i l'Activitat, Servei Català de la Salut, Travessera de les Corts, 131-159, 08028 Barcelona, Spain.
Emili
E
Vela
Grup de Recerca en Addiccions Clínic, Institut Clínic de Neurosciències, Universitat de Barcelona, Villarroel, 170, 08036 Barcelona, Spain.|Spanish Network of Addictive Disorders (RTA). RETICS, Sinesio Delgado, 4, 28029 Madrid, Spain.
Anna
A
Lligoña
Divisió d'Anàlisi de la Demanda i l'Activitat, Servei Català de la Salut, Travessera de les Corts, 131-159, 08028 Barcelona, Spain.
Montserrat
M
Bustins
Program on Substance Abuse, Public Health Agency of Catalonia, Government of Catalonia, Roc Boronat, 81-95, 08005 Barcelona, Spain.
Joan
J
Colom
Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, M5S 2S1, Canada.|Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada.|Department of Psychiatry, Faculty of Medicine, University of Toronto, 1 King's College Circle, Room 2374, Toronto, ON M5S 1A8, Canada.|PAHO/WHO Collaborating Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada.|Epidemiological Research Unit, Klinische Psychologie & Psychotherapie, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
Jürgen
J
Rehm
D000293:Adolescent; D000328:Adult; D000368:Aged; D064829:Alcohol Abstinence / Q000639:trends*; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000639:trends*; D000437:Alcoholism / Q000453:epidemiology* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007297:Inpatients; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult