Healthcare system use by risky alcohol drinkers: A secondary data analysis

Abstract

Purpose: To examine the effects of at-risk alcohol use on patterns of healthcare use and health outcomes.

Data sources: Using the National Health Interview Survey and the Medical Expenditures Panel Survey, a total sample of 4449 adults, mean age 45 (SD 15), were grouped according to responses to the question: "In the past year, on how many days did you have 5 or more drinks of any alcoholic beverage?"

Conclusions: Three categories of respondents were grouped as follows: not at-risk group = 0 days of 5+ drinks/day (n = 2991, 67%); the low at-risk group = 1-11 days of 5+ drinks/day (n = 796, 18%); and the high at-risk group = 12-365 days of 5+ drinks/day (n = 662, 15%). The level of risky alcohol use did not predict healthcare use or healthcare outcomes; high at-risk alcohol drinkers were less likely to use the healthcare system than other drinkers. When divided by rural versus urban living, rural high at-risk alcohol drinkers reported more emergency department visits and all rural living groups reported poorer physical and mental health than their urban counterparts.

Implications for practice: Risky alcohol use, defined as drinking above low-risk guidelines, affects 3 out of 10 adults, and risky drinking plays a role in over 60 chronic health conditions. Nurse practitioners encounter risky alcohol users in multiple practice settings. It may be difficult to identify the underlying alcohol issues, particularly in those living in rural settings; however, identification of at-risk drinkers is essential for prompt intervention in the potential progression from risky alcohol use to an alcohol use disorder.