THE EFFECT OF CHANGES IN ALCOHOL-CONSUMPTION ON MORTALITY AND ADMISSIONS WITH ALCOHOL-RELATED DIAGNOSES IN STOCKHOLM COUNTY - A TIME-SERIESANALYSIS

To study the effect of changes in per capita alcohol sales and indicat ors of alcoholism treatment on admissions to inpatient care and mortal ity for liver cirrhosis and alcoholism, alcohol intoxication and alcoh ol psychosis (AAA). Design. Bivariate and multivariate time series ana lyses was conducted by applying the ARIMA-modelling technique. Setting and participants. All analyses were conducted on quarterly data from Stockholm County 1980-44 with a population of 1.7 million people. Meas urements. Data on sales of alcohol and disulfiram/calcium carbimide we re used as input variables. Inpatient data (from the Stockholm Inpatie nt Care Register) and mortality data (from the Cause of Death Register ) on all cases with alcoholism, alcohol psychosis and alcohol intoxica tion (AAA) and liver cirrhosis as underlying or contributory diagnoses were wed as output variables. Findings. Alcohol sales affected the ci rrhosis rate. For cirrhosis mortality, but not for cirrhosis admission s, the effect was not only direct but also distributed over time. Sign ificant direct and time lag effects of alcohol sales on both AAA serie s and cirrhosis admissions were found only during earlier, shorter per iods, e.g. 1980-90. All four output series showed significant effects of sales of disulfiram/calcium carbimide and were the only significant predictors for the two AAA end points for the whole study period. Con clusions. These results suggest that to reduce the rate of alcohol-rel ated problems caused by socially deteriorated and severely alcohol-dep endent subjects (i.e. AAA), reduction of overall consumption should be complemented by treatment of alcohol-dependent subjects.