ALCOHOL-USE AMONG HMO PATIENTS IN THE EMERGENCY ROOM, PRIMARY-CARE AND THE GENERAL-POPULATION

Objective: Although heavy drinking and alcohol-related problems are ov errepresented among patients seen in some primary care settings compar ed to the general population, it is not known whether those seen for n oninjury problems in emergency rooms (ERs) are similar in demographic and drinking characteristics to those seen in primary care clinics. No r do we know whether alcohol-related problems are overrepresented in b oth of these settings compared to the general population when equal ac cess to health care services is provided, as by membership in the same HMO. Reported here are data from a single northern California health maintenance organization (HMO). Method: Probability samples of noninju red patients seen in the ERs of the HMO (n = 579) are compared on demo graphic characteristics and drinking patterns and problems to those se en in the primary care clinics of the same HMO (n = 295) and to those in the general population of the same county who reported membership i n the HMO (n = 737). Results: No differences in drinking patterns, alc ohol-related problems or gender or age distribution were found between the clinic patients and the noninjured ER patients. Both the noninjur ed ER patients and the clinic patients were less likely to report heav y and problem drinking, or treatment for an alcohol-related problem du ring the last year, as compared to those in the general population. Co nclusions: The data from this HMO study suggest that noninjured patien ts seen in these particular emergency rooms resemble those seen in pri mary care, and that, contrary to the commonly held belief that alcohol -related problems are overrepresented in primary care, primary care pa tients in this HMO population may be less likely to be problem drinker s than those in the general population from which they come.