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J Behav Health Serv Res. 2017 Oct;44(4):602-624. doi: 10.1007/s11414-016-9529-4.

The Association Between Unhealthy Alcohol Use and Acute Care Expenditures in the 30 Days Following Hospital Discharge Among Older Veterans Affairs Patients with a Medical Condition.

Author information

1
Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA. ljchavez@uw.edu.
2
Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA. ljchavez@uw.edu.
3
Health Services Research & Development, Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.
4
Department of Health Services, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
5
Bates College, 2 Andrews Rd, Lewiston, ME, 04240, USA.
6
Department of Pharmacy, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
7
Center of Excellence in Substance Abuse Treatment and Education, Veterans Affairs Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.
8
Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA.
9
Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA.

Abstract

Hospital readmissions and emergency department (ED) visits within 30 days of discharge are costly. Heavy alcohol use could predict increased risk for post-discharge acute care. This study assessed 30-day acute care utilization and expenditures for different categories of alcohol use. Veterans Affairs (VA) patients age ≥65 years with past-year alcohol screening, hospitalized for a medical condition, were included. VA and Medicare health care utilization data were used. Two-part models adjusted for patient demographics. Among 416,050 hospitalized patients, 25% had 30-day acute care use. Nondrinking patients (n = 267,746) had increased probability of acute care use, mean utilization days, and expenditures (difference of $345; 95% CI $268-$423), relative to low-risk drinkers (n = 105,023). High-risk drinking patients (n = 5,300) had increased probability of acute care use and mean utilization days, but not expenditures. Although these patients did not have greater acute care expenditures than low-risk drinking patients, they may nevertheless be vulnerable to poor post-discharge outcomes.

KEYWORDS:

Alcohol Screening; Emergency Department Visit; Index Hospitalization; Unplanned Readmission; Veteran Affair

PMID:
27585803
PMCID:
PMC5332352
DOI:
10.1007/s11414-016-9529-4
[Indexed for MEDLINE]
Free PMC Article

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