Screening for alcoholism by life-style risk assessment in a community hospital

In a community hospital, physicians identified with unusually high frequency (90%) the alcoholics they admitted to a medical-surgical service when life-style risk assessment was performed routinely. Identification rates were retrospectively evaluated based on chart documentation; 100 consecutive admissions receiving assessment interviews were compared with 100 consecutive admissions for a period 6 months later. During the screening period, plans addressing alcohol-related problems routinely appeared in the discharge summaries (71%), referral recommendations were frequently made for residential alcoholism treatment (52%), and intentions were stated to follow-up alcohol abuse problems in the office (43%). Decreases in these rates were observed when life-style risk assessment was not performed. Identification was made in 57% of patients; plans were stated concerning alcohol-related problems in 29%; residential referral was recommended in 5%; and office follow-up was arranged for 24%. The risk assessment program was economical and well received by the patients, the physician staff, and the hospital administration. No specialized program for physician education was utilized.