Cj. Cherpitel et al., ALCOHOL-USE AND MEDICAL-CARE UTILIZATION AMONG HEALTH MAINTENANCE ORGANIZATION PATIENTS IN THE EMERGENCY DEPARTMENT, Academic emergency medicine, 3(2), 1996, pp. 106-113
Objective: To determine the association of an alcohol-related ED visit
with medical care utilization during a two-year period surrounding th
e ED visit in an HMO. Methods: A probability sample of ED patients wer
e interviewed and underwent breath analysis in a large HMO in a Northe
rn California county. Based on recent alcohol intake or documentation
of an alcohol-related ED visit, the patients were assigned to an alcoh
ol group (n = 91) or a non-alcohol group (n 897). A 10% random sample
of the health plan membership of the same county (n = 19,968) served a
s a comparison group. Utilization data were obtained from computerized
files. Multiple linear regression was used to determine differences i
n subsequent outpatient visit rates between the alcohol and the non-al
cohol groups. Logistic regression was used to compare the risks of hos
pitalization in the two groups. Results: Annual outpatient visit rates
were 7.8 in the alcohol group and 8.3 in the non-alcohol group (p = 0
.65), controlling for gender, age, and injury status, and were signifi
cantly different from the visit rate of 5.5 for the random health plan
sample (p = 0.0001). No difference was found between the alcohol and
the non-alcohol groups for risk of hospitalization; however, those in
the health plan sample were less than half as likely to be hospitalize
d as were those in the non-alcohol group (odds ratio 0.44, p = 0.002).
Conclusions: No difference was found in utilization of medical servic
es between the alcohol and the nonalcohol groups in this predominantly
white, well-educated HMO ED population. However, both groups used sig
nificantly more inpatient and outpatient services than did the general
HMO membership.