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Association between clinical measures of unhealthy alcohol use and subsequent year hospital admissions in a primary care population
被引:7
作者:
Jack, Helen E.
[1
,6
]
Oliver, Malia M.
[2
]
Berger, Douglas B.
[1
,3
]
Bobb, Jennifer F.
[2
]
Bradley, Katharine A.
[1
,2
,4
]
Hallgren, Kevin A.
[5
]
机构:
[1] Univ Washington, Dept Med, Div Gen Internal Med, 325 9th Ave,POB 359780, Seattle, WA 98104 USA
[2] Kaiser Permanente Washington Hlth Res Inst, 1730 Minor Ave, Suite 1600, Seattle, WA 98101 USA
[3] Vet Affairs Puget Sound Hlth Care Syst, Gen Med Serv, 1660 S Columbian Way, Seattle, WA 98108 USA
[4] Univ Washington, Dept Hlth Syst & Populat Hlth, 4060 E Stevens Way NE, Seattle, WA 98195 USA
[5] Univ Washington, Dept Psychiat & Behav Sci, 1959 NE Pacific St,POB 356560, Seattle, WA 98195 USA
[6] Harborview Med Ctr, Div Gen Internal Med, 325 9th Ave,POB 359780, Seattle, WA 98104 USA
基金:
美国国家卫生研究院;
关键词:
Alcohol use;
Alcohol use disorder;
Healthcare utilization;
Hospitalization;
AUDIT-C;
Acute care settings;
Screening;
SUBSTANCE USE DISORDERS;
AUDIT-C;
SCREENING SCORES;
COMORBIDITY MEASURES;
BRIEF INTERVENTION;
RISK;
DRINKING;
CONSUMPTION;
PREVALENCE;
SEVERITY;
D O I:
10.1016/j.drugalcdep.2023.109821
中图分类号:
R194 [卫生标准、卫生检查、医药管理];
学科分类号:
摘要:
Background: Screening for unhealthy alcohol use in primary care may help identify patients at risk for negative health outcomes.Aims: This study examined the associations between 1) screening with the AUDIT-C (alcohol consumption) and 2) an Alcohol Symptom Checklist (symptoms of alcohol use disorder) and subsequent-year hospitalizations.Methods: This retrospective cohort study was conducted in 29 primary care clinics in Washington State. Patients were screened in routine care (10/1/2016-2/1/2019) with the AUDIT-C (0-12) and administered the Alcohol Symptom Checklist (0-11) if they had AUDIT-C score >= 7. All-cause hospitalizations were measured within 1 year of the AUDIT-C and Alcohol Symptom Checklist. AUDIT-C and Alcohol Symptom Checklist scores were categorized based on previously used cut-points.Findings: Of 305,376 patients with AUDIT-Cs, 5.3% of patients were hospitalized in the following year. AUDIT-C scores had a J-shaped relationship with hospitalizations, with risk for all-cause hospitalizations higher for pa-tients with the AUDIT-C scores 9-12 (12.1%; 95% CI: 10.6-13.7%, relative to a comparison group of those with AUDIT-C scores 1-2 (female)/1-3 (male) (3.7%; 95% CI: 3.6-3.8%), adjusted for socio-demographics. Patients with AUDIT-C >= 7 and Alcohol Symptom Checklist scores reflecting severe AUD were at increased risk of hos-pitalization (14.6%, 95% CI: 11.9-17.9%) relative to those with lower scores.Conclusions: Higher AUDIT-C scores were associated with higher incidence of hospitalizations except among people with low-level drinking. Among patients with AUDIT-C >= 7, the Alcohol Symptom Checklist identified patients at increased risk of hospitalization. This study helps demonstrate the potential clinical utility of the AUDIT-C and Alcohol Symptom Checklist.
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