ALCOHOL-RELATED HOSPITALIZATIONS OF ELDERLY PEOPLE - PREVALENCE AND GEOGRAPHIC-VARIATION IN THE UNITED-STATES

Objective.- To determine the prevalence, geographic variation, and cha rges to Medicare of alcohol-related hospitalizations among elderly peo ple in the United States. Design.- A cross-sectional prevalence study using 1989 hospital claims data from the Health Care Financing Adminis tration (HCFA). Rates were determined using (1) hospital claims record s from the HCFA's Medicare Provider Analysis and Review Record (MEDPAR ) database for all Medicare Part A beneficiaries aged 65 years and old er, (2) county population estimates for 1985 from the Bureau of the Ce nsus; and (3) per capita consumption of alcohol by state in 1989 as es timated by the US Department of Health and Human Services. Setting.- D ata include all hospital inpatient Medicare Part A beneficiaries aged 65 years and older in the United States in 1989. Results.- The prevale nce of alcohol-related hospitalizations among people aged 65 years and older nationality in 1989 was 54.7 per 10 000 population for men and 14.8 per 10 000 for women. Comparison with hospital records showed tha t MEDPAR data had a sensitvity of 77% to detect alcohol-related hospit alizations. There was considerable geographic variation; prevalence ra nged from 18.9 per 10 000 in Arkansas to 77.0 per 10 000 in Alaska. A strong correlation existed between alcohol-related hospitalizations an d per capita consumption of alcohol by state (Spearman correlation coe fficient, .64; P<.0001). In 1989, the hospital-associated charges to M edicare for all admissions where the primary diagnosis was alcohol rel ated (N=33 039) totaled $233 543 500. Median charge per hospital stay was $4514. Conclusions.- Alcohol-related hospitalizations among elderl y people are common; rates were similar to those for myocardial infarc tion as detected by the same method. The charges to Medicare for this preventable problem are considerable. Ecological analysis suggests tha t per capita consumption in the total US population predicts alcohol-r elated hospitalizations in the elderly population.