HOSPITAL RESOURCE UTILIZATION BY AMERICAN-INDIANS ALASKA NATIVES FOR ALCOHOLISM AND ALCOHOL-ABUSE

Previous work examining the issue of alcoholism and alcohol abuse amon g American Indians and Alaska Natives can be broadly categorized as ei ther descriptions of the consumption patterns and behaviors of specifi c tribes or mortality studies, focusing on deaths due to alcoholism, a lcohol abuse, chronic liver disease, or cirrhosis. A major shortcoming of previous studies has been that they have not looked at the burden this problem has imposed upon the system of health care delivery for t his minority population. By using an International Classification of D iseases, Ninth Revision, Clinical Modification taxonomy of diagnostic codes developed by the National Institute on Alcoholism and Alcohol Ab use (NIAAA) and the national Indian Health Service (IHS) inpatient dat abase for direct and contract admissions, utilization patterns for 43 IHS facilities were investigated. The period of study was 1980-1988, a nd our case definition included any individual 14 years and older who had any mention upon discharge of an alcohol-related diagnosis (ARD). For the 9-year period under investigation, 43,302 adult inpatient admi ssions occurred at the 43 IHS facilities for ARD. These admissions acc ounted for an overall estimated per annum rate of 13.7% of the adult i npatient days. In addition, age and gender specific discharge rates fo r ARD were estimated and compared to reported ARD discharge rates of t he United States civilian population prepared by the NIAAA using the N ational Hospital Discharge Survey over the period 1979-1988. In contra st, the IHS discharge rates for ARD were three times greater than repo rted ARD discharge rates for the United States civilian population.