Alcohol intoxication/dependence, ethnicity and utilisation of health care resources in a level I trauma center

作者：Roudsari Bahman^*; Caetano Raul; Field Craig

来源：Injury-International Journal of the Care of the Injured, 2011, 42(1): 66-71.

DOI：10.1016/j.injury.2010.01.097

• Injury
• Trauma
• Alcohol intoxication
• Alcohol dependence
• Resource utilisation
• Health care
• Resources
• Minorities

Objective: To evaluate the potential influence of acute intoxication and dependence to alcohol on extra-utilisation of health care resources by ethnic minority trauma patients in a level I trauma center.
Methods: We analysed the data of 1493 patients enrolled in a study that evaluated the effectiveness of brief alcohol intervention among ethnic minority trauma patients. The database included detailed demographic, injury-related and drinking-related characteristics (including acute intoxication and alcohol dependency status). Patients were categorised into the following groups: non-intoxicate/non-dependent (NI/ND), non-intoxicated/dependent (NI/D), intoxicated/non-dependent (I/ND) and intoxicated/dependent (I/D). We compared utilisation of several diagnostic and therapeutic procedures among these four categories. We placed special emphasis on ethnicity as a potential effect modifier.
Results: Relative to NI/ND trauma patients, I/ND patients (relative risk (RR): 1.8, 95% CI: 1.2-2.8) and I/D patients (RR: 2.4, 95% CI: 1.6-3.6) had significantly higher chance of being evaluated by abdominal ultrasound during the first 24 h of hospital arrival. Similar pattern was observed for head CT scan (with the corresponding RRs of 2.1 and 2.6, respectively). Chance of admission to the intensive care unit (ICU) was not associated with intoxication/dependence status. Length of hospital stay was negatively associated with drinking status with the shortest length of stay for I/D. Including ethnicity in the models, did not change the results and conclusions.
Discussion: Acute intoxication and dependence to alcohol are both associated with more frequent utilisation of selected health care resources and the utilisation pattern was not associated with patient ethnicity. This emphasises on the importance of routine screening for drinking problems among all trauma patients, regardless of their blood alcohol level in the ED.

• 出版日期2011-1