Prevalence of alcohol-related attendance at an inner-city emergency department and its impact: a dual prospective and retrospective cohort study

K. N. (Kathryn) Parkinson, Dorothy Newbury-Birch, Angela Phillipson, Paul Hindmarch, Eileen Kaner, Elaine Stamp, Luke Vale, John Wright, Jim Connolly

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    Abstract

    Background: Alcohol-related hospital attendances at Emergency Departments (ED) are a potentially avoidable burden on National Health Services (NHS) resources. Understanding the number and type of patients attending EDs with alcohol intoxication is important in estimating the workload and cost implications. We used best practice from previous studies to establish the prevalence of adult alcohol-related ED attendances and estimate the costs of clinical management and subsequent health service use. Methods: The setting was a large inner-city ED in northeast England, United Kingdom. Data were collected via (i) retrospective review of hospital records for all ED attendances for four pre-specified weeks in 2010/11 to identify alcohol-related cases along with 12 months follow-up of the care episode, and (ii) prospective 24/7 assessment via breath alcohol concentration testing of patients presenting to ED in the corresponding weeks in 2012/13. Results: The prevalence rates of alcohol-related attendances were 12% and 15% for the retrospective and prospective cohorts. Prospectively, the rates ranged widely from 4% to 60% during the week, rising to over 70% at weekends. Younger males attending in the early morning hours at weekends made up the largest proportion of alcohol-related attendances. The mean cost per attendance was £249 (SD £1,064); the mean total cost for those admitted was £851 (SD £2,549). The most common reasons for attending were trauma-related injuries, followed by psychiatric problems. Conclusions: Alcohol-related attendances are a major and avoidable burden on emergency care. However, targeted interventions at weekends and early morning hours could capture the majority of cases and help prevent future re-attendance.
    Original languageEnglish
    Pages (from-to)-
    JournalEmergency Medicine Journal
    Volume33
    Issue number3
    DOIs
    Publication statusPublished - 2015

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    Hospital Emergency Service
    Cohort Studies
    Retrospective Studies
    Alcohols
    Costs and Cost Analysis
    Alcoholic Intoxication
    Aftercare
    Hospital Records
    Health Resources
    Wounds and Injuries
    National Health Programs
    Emergency Medical Services
    Workload
    Practice Guidelines
    England
    Health Services
    Psychiatry

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    Parkinson, K. N. (Kathryn) ; Newbury-Birch, Dorothy ; Phillipson, Angela ; Hindmarch, Paul ; Kaner, Eileen ; Stamp, Elaine ; Vale, Luke ; Wright, John ; Connolly, Jim. / Prevalence of alcohol-related attendance at an inner-city emergency department and its impact: a dual prospective and retrospective cohort study. In: Emergency Medicine Journal. 2015 ; Vol. 33, No. 3. pp. -.
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    title = "Prevalence of alcohol-related attendance at an inner-city emergency department and its impact: a dual prospective and retrospective cohort study",
    abstract = "Background: Alcohol-related hospital attendances at Emergency Departments (ED) are a potentially avoidable burden on National Health Services (NHS) resources. Understanding the number and type of patients attending EDs with alcohol intoxication is important in estimating the workload and cost implications. We used best practice from previous studies to establish the prevalence of adult alcohol-related ED attendances and estimate the costs of clinical management and subsequent health service use. Methods: The setting was a large inner-city ED in northeast England, United Kingdom. Data were collected via (i) retrospective review of hospital records for all ED attendances for four pre-specified weeks in 2010/11 to identify alcohol-related cases along with 12 months follow-up of the care episode, and (ii) prospective 24/7 assessment via breath alcohol concentration testing of patients presenting to ED in the corresponding weeks in 2012/13. Results: The prevalence rates of alcohol-related attendances were 12{\%} and 15{\%} for the retrospective and prospective cohorts. Prospectively, the rates ranged widely from 4{\%} to 60{\%} during the week, rising to over 70{\%} at weekends. Younger males attending in the early morning hours at weekends made up the largest proportion of alcohol-related attendances. The mean cost per attendance was £249 (SD £1,064); the mean total cost for those admitted was £851 (SD £2,549). The most common reasons for attending were trauma-related injuries, followed by psychiatric problems. Conclusions: Alcohol-related attendances are a major and avoidable burden on emergency care. However, targeted interventions at weekends and early morning hours could capture the majority of cases and help prevent future re-attendance.",
    author = "Parkinson, {K. N. (Kathryn)} and Dorothy Newbury-Birch and Angela Phillipson and Paul Hindmarch and Eileen Kaner and Elaine Stamp and Luke Vale and John Wright and Jim Connolly",
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    language = "English",
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    Prevalence of alcohol-related attendance at an inner-city emergency department and its impact: a dual prospective and retrospective cohort study. / Parkinson, K. N. (Kathryn); Newbury-Birch, Dorothy; Phillipson, Angela; Hindmarch, Paul; Kaner, Eileen; Stamp, Elaine; Vale, Luke; Wright, John; Connolly, Jim.

    In: Emergency Medicine Journal, Vol. 33, No. 3, 2015, p. -.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Prevalence of alcohol-related attendance at an inner-city emergency department and its impact: a dual prospective and retrospective cohort study

    AU - Parkinson, K. N. (Kathryn)

    AU - Newbury-Birch, Dorothy

    AU - Phillipson, Angela

    AU - Hindmarch, Paul

    AU - Kaner, Eileen

    AU - Stamp, Elaine

    AU - Vale, Luke

    AU - Wright, John

    AU - Connolly, Jim

    PY - 2015

    Y1 - 2015

    N2 - Background: Alcohol-related hospital attendances at Emergency Departments (ED) are a potentially avoidable burden on National Health Services (NHS) resources. Understanding the number and type of patients attending EDs with alcohol intoxication is important in estimating the workload and cost implications. We used best practice from previous studies to establish the prevalence of adult alcohol-related ED attendances and estimate the costs of clinical management and subsequent health service use. Methods: The setting was a large inner-city ED in northeast England, United Kingdom. Data were collected via (i) retrospective review of hospital records for all ED attendances for four pre-specified weeks in 2010/11 to identify alcohol-related cases along with 12 months follow-up of the care episode, and (ii) prospective 24/7 assessment via breath alcohol concentration testing of patients presenting to ED in the corresponding weeks in 2012/13. Results: The prevalence rates of alcohol-related attendances were 12% and 15% for the retrospective and prospective cohorts. Prospectively, the rates ranged widely from 4% to 60% during the week, rising to over 70% at weekends. Younger males attending in the early morning hours at weekends made up the largest proportion of alcohol-related attendances. The mean cost per attendance was £249 (SD £1,064); the mean total cost for those admitted was £851 (SD £2,549). The most common reasons for attending were trauma-related injuries, followed by psychiatric problems. Conclusions: Alcohol-related attendances are a major and avoidable burden on emergency care. However, targeted interventions at weekends and early morning hours could capture the majority of cases and help prevent future re-attendance.

    AB - Background: Alcohol-related hospital attendances at Emergency Departments (ED) are a potentially avoidable burden on National Health Services (NHS) resources. Understanding the number and type of patients attending EDs with alcohol intoxication is important in estimating the workload and cost implications. We used best practice from previous studies to establish the prevalence of adult alcohol-related ED attendances and estimate the costs of clinical management and subsequent health service use. Methods: The setting was a large inner-city ED in northeast England, United Kingdom. Data were collected via (i) retrospective review of hospital records for all ED attendances for four pre-specified weeks in 2010/11 to identify alcohol-related cases along with 12 months follow-up of the care episode, and (ii) prospective 24/7 assessment via breath alcohol concentration testing of patients presenting to ED in the corresponding weeks in 2012/13. Results: The prevalence rates of alcohol-related attendances were 12% and 15% for the retrospective and prospective cohorts. Prospectively, the rates ranged widely from 4% to 60% during the week, rising to over 70% at weekends. Younger males attending in the early morning hours at weekends made up the largest proportion of alcohol-related attendances. The mean cost per attendance was £249 (SD £1,064); the mean total cost for those admitted was £851 (SD £2,549). The most common reasons for attending were trauma-related injuries, followed by psychiatric problems. Conclusions: Alcohol-related attendances are a major and avoidable burden on emergency care. However, targeted interventions at weekends and early morning hours could capture the majority of cases and help prevent future re-attendance.

    U2 - 10.1136/emermed-2014-204581

    DO - 10.1136/emermed-2014-204581

    M3 - Article

    VL - 33

    SP - -

    JO - Emergency Medicine Journal

    JF - Emergency Medicine Journal

    SN - 1472-0205

    IS - 3

    ER -