ALCOHOL-USE AND MEDICAL-CARE UTILIZATION AMONG HEALTH MAINTENANCE ORGANIZATION PATIENTS IN THE EMERGENCY DEPARTMENT

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.