Inequity in the hospital care of patients with alcoholism and medication addiction

In a psychiatric/ecological study, the authors investigated which aspects o f a town district would provide an explanation to the fact that alcoholics are treated above average in addiction-psychiatric wards in a given city di strict, while in other districts treatment is carried out in internal medic al wards. The research was based on data collected between 1988 and 1994 fr om approximately 77% of all patients suffering from alcohol and legal drug abuse (n = 15,473) in 41 hospitals in Hamburg. It was established that in s omatic departments, mainly internal medicine, 70% of male and 67% of female patients were admitted for alcohol and legal drug abuse. The results of a geographical analysis of hospitalization risks showed that the addiction-ps ychiatric facilities of psychiatric wards are mainly utilized by inhabitant s from nearby districts. Risks of above-average hospitalization for alcohol ics and legal drug abusers in internal wards, as well as insufficient addic tion-psychiatric care, are to be expected in town districts where a shortag e of psychiatrists exists, and where the unemployment rate is high. In thes e crucial areas, addiction-specific facilities, such as qualified programs for detoxication or techniques for short intervention, should be establishe d within the framework of an addiction-specific liaison service in general hospitals. Copyright (C) 2000 S. Karger AG, Basel.