Do patients with alcohol dependence use more services? A comparative analysis with other chronic disorders

Objective: The primary purpose of this research was to compare the service use of patients diagnosed with alcohol dependence to the service use of pat ients diagnosed with other chronic illnesses. The secondary purpose was to determine the impact of comorbid alcoholism on the service use of patients with chronic illnesses. Methods: The sample included 67,878 veterans diagno sed with alcohol dependence, depression, or diabetes who were treated by th e Department of Veterans Affairs in 1993. The number of inpatient days and outpatient visits over a 4-year period (1991 to 1995) were compared using r egression models to control for differences in casemix. Results: Controllin g for casemix, patients treated for alcohol dependence had significantly fe wer outpatient visits than patients treated for either depression or diabet es. Patients treated for alcohol dependence also had significantly fewer in patient days than patients treated for depression, but significantly more i npatient days than patients treated for diabetes. Comorbid alcoholism was p revalent among patients treated for depression and diabetes. Comorbid alcoh olism increased the number of inpatient days for patients treated for depre ssion or diabetes and increased the number outpatient visits for patients w ith depression. However, comorbid alcoholism decreased the number of outpat ient visits for patients treated for diabetes. Conclusions: Results suggest that patients with alcohol use disorders should not be singled out as bein g more costly to treat than patients with other chronic illnesses. These fi ndings are in stark contrast to those from studies comparing individuals wi th alcohol use disorders to relatively healthy individuals sampled from at- risk populations.