The Association Between Unhealthy Alcohol Use and Acute Care Expenditures in the 30 Days Following Hospital Discharge Among Older Veterans Affairs Patients with a Medical Condition

J Behav Health Serv Res. 2017 Oct;44(4):602-624. doi: 10.1007/s11414-016-9529-4.


Hospital readmissions and emergency department (ED) visits within 30 days of discharge are costly. Heavy alcohol use could predict increased risk for post-discharge acute care. This study assessed 30-day acute care utilization and expenditures for different categories of alcohol use. Veterans Affairs (VA) patients age ≥65 years with past-year alcohol screening, hospitalized for a medical condition, were included. VA and Medicare health care utilization data were used. Two-part models adjusted for patient demographics. Among 416,050 hospitalized patients, 25% had 30-day acute care use. Nondrinking patients (n = 267,746) had increased probability of acute care use, mean utilization days, and expenditures (difference of $345; 95% CI $268-$423), relative to low-risk drinkers (n = 105,023). High-risk drinking patients (n = 5,300) had increased probability of acute care use and mean utilization days, but not expenditures. Although these patients did not have greater acute care expenditures than low-risk drinking patients, they may nevertheless be vulnerable to poor post-discharge outcomes.

Keywords: Alcohol Screening; Emergency Department Visit; Index Hospitalization; Unplanned Readmission; Veteran Affair.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / economics*
  • Alcoholism / diagnosis
  • Alcoholism / economics
  • Databases, Factual
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Expenditures / statistics & numerical data*
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Medicare
  • Patient Readmission / economics
  • United States
  • United States Department of Veterans Affairs / economics
  • Veterans / statistics & numerical data*