TY - JOUR
T1 - Identification and medical utilization of incident cases of alcohol dependence
T2 - A population-based case-control study
AU - Pan, Chun Hung
AU - Li, Min Shan
AU - Yang, Tien Wey
AU - Huang, Ming Chyi
AU - Su, Sheng Shiang
AU - Hung, Yen Ni
AU - Chen, Chiao Chicy
AU - Kuo, Chian Jue
PY - 2018/7/1
Y1 - 2018/7/1
N2 - 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.
AB - 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.
KW - Alcohol dependence
KW - Case identification
KW - Chronic hepatic disease
KW - Comorbidity
KW - Medical utilization
UR - http://www.scopus.com/inward/record.url?scp=85047080324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047080324&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2018.03.046
DO - 10.1016/j.drugalcdep.2018.03.046
M3 - Article
C2 - 29778776
AN - SCOPUS:85047080324
SN - 0376-8716
VL - 188
SP - 216
EP - 223
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
ER -