Identification and medical utilization of incident cases of alcohol dependence: A population-based case-control study

Chun Hung Pan, Min Shan Li, Tien Wey Yang, Ming Chyi Huang, Sheng Shiang Su, Yen Ni Hung, Chiao Chicy Chen, Chian Jue Kuo

Research output: Contribution to journalArticle

Abstract

Background: Patients with alcohol dependence (AD) often seek help from medical professionals due to alcohol-related diseases, but the overall distribution of medical specialties identifying new AD cases is unclear. We investigated how such cases were identified and how medical resources were utilized before the identification of AD in a nationwide cohort. Methods: We enrolled a population-based cohort (N = 1,000,000) using the National Health Insurance Research Database of Taiwan; 8181 cases with incident AD were retrieved between January 1, 2000, and December 31, 2010. For this nested case-control study, four controls were matched for age and sex with each case based on risk-set sampling. We measured various dimensions of medical utilization before AD was diagnosed, including department visited, physical comorbidity, and medication used. Conditional logistic regression was used for estimating the variables associated with AD. Results: Patients living in less urbanized areas who were unemployed were more likely to develop AD. The highest proportions (34.2%) of AD cases were identified in the internal medicine department, followed by the emergency (22.3%) and psychiatry (18.7%) departments. AD patients had a higher risk of comorbid chronic hepatic disease (adjusted RR = 2.72, p < 0.001) before identification of AD than controls. AD patients also had greater numbers of hospital admissions than controls, including non-psychiatric and psychiatric hospitalizations. Outpatient visit numbers were similar for AD patients and controls. Conclusions: The findings indicate that clinicians providing care in diverse medical settings should be prepared to screen for unhealthy alcohol use and to mitigate its detrimental effects.

Original languageEnglish
Pages (from-to)216-223
Number of pages8
JournalDrug and Alcohol Dependence
Volume188
DOIs
Publication statusPublished - Jul 1 2018

Keywords

  • Alcohol dependence
  • Case identification
  • Chronic hepatic disease
  • Comorbidity
  • Medical utilization

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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