ALCOHOL-CONSUMPTION AMONG EMERGENCY ROOM PATIENTS - COMPARISON OF COUNTY COMMUNITY HOSPITALS AND AN HMO

This study examines the associations of drinking patterns and problems to injury vs noninjury status among emergency room (ER) patients. Dat a come from two distinctly different health care systems in the same c ounty: (1) the county hospital and three community hospitals (N = 2,62 6) and (2) the three health maintenance organization (HMO) hospitals ( N = 1, 102). Results indicate that alcohol's role in injury cases seen in the ER differs from its contribution to noninjury cases. Further, the demographic characteristics of ER populations-and the associated d rinking patterns-also vary from site to site, and these also affect th e contribution of alcohol to events requiring ER treatment- Both studi es used similar methods and data collection instruments. Probability s amples of patients were breath analyzed and interviewed regarding self -reported consumption (within 6 hours prior to the injury or illness). usual drinking patterns and alcohol-related problems. In both samples injured were more likely than noninjured to have positive breath-anal yzer readings and to report heavy drinking, more frequent drunkenness, prior alcohol-related accidents and prior treatment for an alcohol-re lated problem, but were no more likely to report harmful consequences of drinking or alcohol dependence experiences during the last year. Bo th injured and noninjured in the county/community sample reported high er rates of heavy and problem drinking than their counterparts in the HMO sample, while those in the HMO sample reported rates for heavy and problem drinking similar to those found in the general population of the county. Using logistic regression to predict injury status, only a breath-analyzer reading was predictive of admission to the ER with an injury in both samples after demographic characteristics were control led, which suggests the importance of routine testing for alcohol amon g injured in ER caseloads.