Skip to main content
SpringerLink
Log in

Alcohol consumption, risk of injury, and high-cost medical care

  • Regular Articles
  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

This study examined the effect of alcohol use on the probabilities of injury, inpatient hospital stay, and emergency department visit. Data were obtained from a sample of adults (N=1219) recruited from a Northern California county. Alcohol use measures included number of drinks, heavy drinking days, and an indicator variable for problem drinking. Models were estimated for men and women separately while controlling for confounders. Results indicate that most alcohol use measures were not significantly related to injury probability or medical care utilization. Among the exceptions, problem drinking was a significant positive predictor of any emergency department visit for both sexes. When drinkers during the past year were divided into light, moderate, and heavy drinking groups and compared to lifetime abstainers, all male drinkers had a higher probability of injury, and light and moderate female drinkers had a lower probability of an emergency department visit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cherpitel J. Injury and the role of alcohol: county-wide emergency room data.Alcohol Clin Exp Res. 1994;18:679–684.

    CAS  PubMed  Google Scholar 

  2. Cornwell E, Belzberg H, Velmahos G, et al. The prevalence and effect of alcohol and drug abuse on cohort-matched critically injured patients.Am Surg. 1998;65(5):461–465.

    Google Scholar 

  3. Dikmen SS, Machamer JE, Donovan DM, et al. Alcohol use before and after traumatic head injury.Ann Emerg Med. 1995;26:167–176.

    Article  CAS  PubMed  Google Scholar 

  4. McLeod R, Stockwell T, Rooney R, et al. The influence of extrinsic and intrinsic risk factors on the probability of sustaining an injury.Accid Anal Prev. 2003;35:71–80.

    Article  PubMed  Google Scholar 

  5. Fabbri A, Marchesini G, Dente M, et al. A positive blood alcohol concentration is the main predictor of recurrent vehicle crash.Ann Emerg Med. 2005;46(2):161–167.

    Article  PubMed  Google Scholar 

  6. Schepens PJ, Pauwels A, Van Damme P. Drugs of abuse and alcohol in weekend drivers involved in car crashes in Belgium.Ann Emerg Med. 1998;31:633–637.

    Article  CAS  PubMed  Google Scholar 

  7. Stockwell T, McLeod R, Stevens M, et al. Alcohol consumptions, setting, gender and activity as predictors of injury: a population-based case-control study.J Stud Alcohol. 2002;63:372–379.

    PubMed  Google Scholar 

  8. Cherpitel CJ. Alcohol and injuries: a review of international emergency room studies.Addiction. 1993;88:923–937.

    CAS  PubMed  Google Scholar 

  9. Cherpitel CJ. Alcohol consumption among emergency room patients: comparison of county/community hospitals and an HMO.J Stud Alcohol. 1993;54(4):432–440.

    CAS  PubMed  Google Scholar 

  10. Cherpitel CJ. Alcohol-related health services use and identification of patients in the emergency department.Ann Emerg Med. 1996;28:418–423.

    Article  CAS  PubMed  Google Scholar 

  11. Treno AJ, Gruenewald PJ, Johnson FW. Sample selection bias in the emergency room: an examination of the role of alcohol in injury.Addiction. 1998;93:113–129.

    Article  CAS  PubMed  Google Scholar 

  12. Cherpitel CJ. Emergency room and primary care services utilization and associated alcohol and drug use in the United States general population.Alcohol Alcohol. 1999;34(4):581–589.

    CAS  PubMed  Google Scholar 

  13. Alexandre PK, Roebuck MC, French MT, et al. Problem drinking, health services utilization, and the cost of medical care.Recent Devel Alcohol. 2001;15:285–298.

    CAS  Google Scholar 

  14. Cryer PC, Jenkins LM, Cook AC, et al. The use of acute and preventative medical services by a general population: relationship to alcohol consumption.Addiction. 1999;94:1523–1532.

    Article  CAS  PubMed  Google Scholar 

  15. Li G, Smith GS, Baker SP. Drinking behavior in relation to cause of death among US adults.Am J Public Health. 1994;84:1402–1406.

    CAS  PubMed  Google Scholar 

  16. Rice DP, Conell C, Weisner C, et al. Alcohol drinking patterns and medical care use in an HMO setting.J Behav Health Serv Res. 2000;27(1):3–16.

    Article  CAS  PubMed  Google Scholar 

  17. Hunkeler EM, Hung Y, Rice DP, et al. Alcohol consumption patterns and health care costs in an HMO.Drug Alcohol Depend. 2001;64:181–190.

    CAS  PubMed  Google Scholar 

  18. Murray RP, Connett JE, Tyas SL, et al. Alcohol volume, drinking pattern, and cardiovascular disease morbidity and mortality: is there a U-shaped function?Am J Epidemiol. 2002;155(3):242–248.

    Article  PubMed  Google Scholar 

  19. Zakhari S, Gordis E. Moderate drinking and cardiovascular health.Proc Assoc Am Physicians. 1999;111(2):148–158.

    Article  CAS  PubMed  Google Scholar 

  20. Weisner CM, Matzger H. A prospective study of the factors influencing entry to alcohol and drug treatment.J Behav Health Serv Res. 2002;29(2):126–137.

    Article  PubMed  Google Scholar 

  21. Weisner CM, Matzger H, Kaskutas LA. How important is treatment? One year outcomes of treated and untreated alcohol-dependent individuals.Addiction. 2003;98(7):901–911.

    Article  PubMed  Google Scholar 

  22. Greenfield TK, Weisner C. Drinking problems and self-reported criminal behavior, arrests and convictions: 1990 US alcohol and 1989 county surveys.Addiction. 1995;90(3):361–373.

    Article  CAS  PubMed  Google Scholar 

  23. Kaskutas LA, Weisner C, Caetano R. Predictors of help seeking among a longitudinal sample of the general population, 1984–1992.J Stud Alcohol. 1997:58(2);155–161.

    CAS  PubMed  Google Scholar 

  24. Roizen R.The World Health Organization Study of Community Responses to Alcohol-related Problems: a Review of Cross-cultural Findings. Geneva: World Health Organization; 1981.

    Google Scholar 

  25. Schmidt L, Weisner C, Wiley J. Substance abuse and the course of welfare dependency.Am J Public Health. 1998:88(11);1616–1622.

    CAS  PubMed  Google Scholar 

  26. Weisner CM, Kaskutas LA, Hilton ME, et al. ‘When you were drinking’ vs. ‘in the past 12 months’: the impact of using different time frames in clinical and general populations.Addiction. 1999;94(5):731–736.

    Article  CAS  PubMed  Google Scholar 

  27. Weisner C, Schmidt L. Gender disparities in treatment for alcohol problems.JAMA. 1992;268(14):1872–1876.

    Article  CAS  PubMed  Google Scholar 

  28. Weisner C, Schmidt L. The Community Epidemiology Laboratory: studying alcohol problems in community- and agency-based populations.Addiction. 1995;90(3):329–342.

    CAS  PubMed  Google Scholar 

  29. Office of Applied Studies.Uniform Facility Data Set (UFDS): Data for 1980–1996. Rockville, Md: Substance Abuse and Mental Health Services Administration; 1998.

    Google Scholar 

  30. Schmidt L, Weisner C. Developments in alcoholism treatment: a ten year review. In: Galanter M, ed.Recent Developments in Alcoholism. New York, NY: Plenum Press; 1993:369–396.

    Google Scholar 

  31. Weisner C, Greenfield T, Room R. Trends in the treatment of alcohol problems in the US general population, 1979 through 1990.American Journal of Public Health. 1995;85(1):55–60.

    CAS  PubMed  Google Scholar 

  32. Weisner C, Schmidt L. Rethinking access to alcohol treatment. In: Galanter M, ed.Recent Developments in Alcoholism, Vol 15: Services Research in the Era of Managed Care. New York: Kluwer Academic/Plenum Press; 2001:107–136.

    Google Scholar 

  33. NIAAA. Percent distribution of current drinking status, drinking levels, and heavy drinking days by sex for persons 18 years of age and older: United Status, NHIS, 1997–2002. Available at: http://www.niaaa.nih.gov/databases/dkpat25/. Accessed September 17, 2004.

  34. Okuyemi KS, Frey B. Describing and predicting frequent users of an emergency department.J Assoc Acad Minor Phys. 2001;12(1–2):119–123.

    CAS  PubMed  Google Scholar 

  35. Poikolainen K. Risk of alcohol-related hospital admissions by marital status and social class among females.Drug Alcohol Depend. 1983;10(2–3):159–164.

    Google Scholar 

  36. Selassie AW, McCarthy ML, Pickelsimer EE. The influence of insurance, race, and gender on emergency department disposition.Acad Emerg Med. 2003;10(11):1260–1270.

    Article  PubMed  Google Scholar 

  37. Ruger JP, Richter CJ, Lewis LM. Association between insurance status and admission rate for patients evaluated in the emergency department.Acad Emerg Med. 2003;10(11):1285–1288.

    Article  PubMed  Google Scholar 

  38. Sox CM, Burstin HR, Edwards RA, et al. Hospital admissions through the emergency department: does insurance status matter?Am J Med. 1998;105(6):506–512.

    Article  CAS  PubMed  Google Scholar 

  39. Svenson JE, Spurlock CW. Insurance status and admission to hospital for head injuries: are we part of a two-tiered medical system?Am J Emerg Med. 2001;19(1):19–24.

    CAS  PubMed  Google Scholar 

  40. Price C, Makintubee S, Herndon W, et al. Epidemiology of traumatic spinal cord injury and acute hospitalization and rehabilitation charges for spinal cord injuries in Oklahoma, 1988–1990.Am J Epidemiol. 1994;139(1):37–47.

    CAS  PubMed  Google Scholar 

  41. Woodruff BA, Baron RC. A description of nonfatal spinal cord injury using a hospital-based registry.Am J Prev Med. 1994;10(1):10–14.

    CAS  PubMed  Google Scholar 

  42. McLeod R, Stockwell T, Stevens M, et al. The relationship between alcohol consumption patterns and injury.Addiction. 1999;94(11):1719–1734.

    Article  CAS  PubMed  Google Scholar 

  43. Hung YC, Montazem A, Costello MA. The correlation between mandible fractures and loss of consciousness.J Oral Maxillofac Surg. 2004;62(8):938–942.

    Article  PubMed  Google Scholar 

  44. Laski R, Ziccardi VB, Broder HL, Janal M. Facial trauma: a recurrent disease? The potential role of disease prevention.J Oral Maxillofac Surg. 2004;62(6):685–688.

    Article  PubMed  Google Scholar 

  45. Gerhart KA, Mellick DC, Weintraub AH. Violence-related traumatic brain injury: a population-based study.J Trauma. 2003;55(6):1045–1053.

    PubMed  Google Scholar 

  46. Zavala SK, French MT. Dangerous to your health: the role of chronic drug use in serious injuries and trauma.Med Care. 2003;41(2):309–322.

    Article  PubMed  Google Scholar 

  47. Bound J, Jaeger DA, Baker RM. Problems with instrumental variables estimation when correlation between the instruments and the endogenous explanatory variable is weak.J Am Stat Assoc. 1995;90:443–450.

    Google Scholar 

  48. Manning WG, Duan N, Rogers WH. Monte Carlo evidence on the choice between sample selection and two-part models.J Econometr. 1987;35:59–79.

    Google Scholar 

  49. Mullahy J. Much ado about two: reconsidering retransformation and the two-part model in health econometrics.J Health Econ. 1998;17:247–281.

    Article  CAS  PubMed  Google Scholar 

  50. Norton EC, Lindrooth RC, Ennett ST. Controlling for the endogeneity of peer substance use on adolescent alcohol and tobacco use.Health Econ. 1998;7:439–453.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Sociology, University of Miami, 5202 University Dr, Merrick Bldg, Room 121F, PO Box 248162, 33124, Coral Gables, FL

    Michael T. French PhD (Professor of Health Economics)

  2. Novilogic, Inc., Fort Lauderdale, Fla.

    Helena J. Salomé MA (a health economist)

  3. the Department of Sociology, University of Miami, Coral Gables, Fla.

    Michael T. French PhD (a professor of health economics)

  4. the Department of Psychiatry, University of California, San Francisco, Calif.

    Helen Matzger MPH (a senior statistician)

  5. Department of Psychiatry, University of California, San Francisco, Calif.

    Constance Weisner DrPH, MSW (a professor)

  6. Kaiser Permanente Division of Research, Oakland, Calif.

    Constance Weisner DrPH, MSW (a professor)

Authors
  1. Michael T. French PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Helena J. Salomé MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael T. French PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Helen Matzger MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Constance Weisner DrPH, MSW
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael T. French PhD.

Additional information

This study was initiated by investigators at the Alcohol Research Group (ARG).

Financial assistance for this study was provided by research grants (R01 AA09750 and R01 AA13167) from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), US Department of Health and Human Services. We are grateful to Lee Kaskutas, DrPH, for her helpful suggestions on earlier versions of the article and to William Russell for his editorial assistance. The authors are entirely responsible for the research reported in this article, and their positions or opinions do not necessarily represent those of the NIAAA; the University of Miami; the University of California, San Francisco; Kaiser Permanente; or NoviLogic, Inc.

Rights and permissions

Reprints and permissions

About this article

Cite this article

French, M.T., Salomé, H.J., French, M.T. et al. Alcohol consumption, risk of injury, and high-cost medical care. The Journal of Behavioral Health Services & Research 32, 368–380 (2005). https://doi.org/10.1007/BF02384198

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02384198

Keywords

Search

Navigation