The profile, clinical characteristics, and outcomes of alcohol- and non-alcohol-related patient presentations to Queensland emergency departments: a multi-site observational study
Julia Crilly
A B C * , Katie East D , Josea Brown A , Ping Zhang C , Josh Byrnes E , Jeremy Furyk F G , Jill Duncan H , Leonie Jones I , Nathan J. Brown H J , David Green A C , Sean Rothwell H and David Rosengren H J
A Department of Emergency Medicine, Gold Coast Hospital and Health Service, Qld, Australia.
B School of Nursing and Midwifery, Griffith University, Qld, Australia.
C Menzies Health Institute Queensland, Griffith University, Qld, Australia.
D Department of Emergency Medicine, Metro South Hospital and Health Service, Qld, Australia.
E Centre for Applied Health Economics, School of Medicine, Griffith University, Qld, Australia.
F Department of Emergency Medicine, University Hospital Geelong, Vic., Australia.
G Faculty of Health, Deakin University, Vic., Australia.
H Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital, Qld, Australia.
I Emergency Department, Townsville University Hospital, Townsville, Qld, Australia.
J Faculty of Medicine, The University of Queensland, Qld, Australia.
Australian Health Review 46(6) 701-709 https://doi.org/10.1071/AH22161
Submitted: 1 July 2022 Accepted: 3 November 2022 Published: 1 December 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objective The harmful use of alcohol is a global issue. This study aimed to describe and compare the profiles, emergency department (ED) clinical characteristics, and outcomes of alcohol-related ED presentations (ARPs) and non-alcohol-related ED presentations (NARPs).
Methods A multi-site observational study of all presentations to four EDs between 4 April 2016 and 31 August 2017, was conducted. Routinely collected ED clinical, administrative and costings data were used. Classification of ARPs were prospectively recorded by clinicians. Analysis was performed at the presentation, rather than person level. Univariate tests were undertaken to compare demographics, ED clinical characteristics and outcomes between ARPs and NARPs.
Results A total of 418 051 ED presentations occurred within the 17-month study period; 5% (n = 19 875) were ARPs. Presentations made by people classified as ARPs were younger, more likely to be male, present on weekends or at night, and arrive by ambulance or police compared to NARPs. Compared with NARPs, ARPs had a longer median ED length of stay of over 20 min (95% CI 18–22, median 196 min vs 177 min, P < 0.001), a 5.5% (95% CI 4.9–5.3) lower admission rate (36% vs 42%, P < 0.001), and a AUD69 (95% CI 64–75) more expensive ED episode-of-care (AUD689 vs AUD622, P < 0.001).
Conclusion Clinically meaningful differences were noted between alcohol-related and non-alcohol-related ED presentations. The higher cost of care for ARPs likely reflects their longer time in the ED. The healthcare and economic implications of incidents of alcohol-related harm extend beyond the ED, with ARPs having higher rates of ambulance and police use than NARPs.
Keywords: alcohol, Australia, emergency department, health economics, observational study, outcomes, prehospital, service delivery.
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