Two methods of estimating health costs linked to alcoholism in France (with a note on social costs)

The health costs of alcohol-related problems in France were estimated using two cost evaluation approaches: (1) estimate based on the proportion of ca ses attributable to alcohol abuse (the alcohol abuse factor); (2) estimate based on prevalence of alcohol abuse for in- and out-patients. For a 10% pr evalence of alcohol abuse in the general population, the minimum cost in 19 96 was about US$ 2300 million; for a prevalence of 15% it was US$ 2700 mill ion. This cost concerns the health disorders that are linked directly or in directly to alcohol abuse. It did not allow for injuries from accidents cau sed by alcohol intoxication and undervalued the cost of outpatient care. Ba sed on the prevalence of alcohol-related disorders seen at hospitals, a per centage of the total in-patient and out-patient costs due to effects of alc ohol could be estimated. However, this did not permit an estimate of the co st of care in which alcohol abuse was a risk factor only. Based on the avai lable data showing that between 3% and 10% of inpatients have a directly al cohol-related condition, estimates of in-patient treatment costs varied fro m US$ 1300 to 2100 million. Among adult out-patients, 20% present with a di sorder in which alcohol is a factor or suffer from an alcohol-related illne ss, which corresponds to a cost of about US$ 1600 million. Thus, these meth ods yield minimum year's cost estimated between US$ 2500 and 3300 million. These costs are high, compared to the low level of financing for the specia lized facilities offering treatment to people in difficulty due to alcohol excess, which was US$ 23 million in that year. As regards social and total costs, estimates from four Western countries have found that about 75% of t he total costs of alcohol abuse was attributable to social harm, and 25% to medical costs. Applying this ratio to the French data gives an estimated t otal cost to French society of about US$ 13 200 million, i.e. 1.04% of the gross national product.