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Alcohol-related harm in emergency departments: linking to subsequent hospitalizations to quantify under-reporting of

Scott Sims^1,2, David Preen², Gavin Pereira^1,3,4

¹Telethon Kids Institute, Perth, Australia.

Addiction (Abingdon, England)

|October 7, 2020

Abstract

Title:

Alcohol-related harm in emergency departments: linking to subsequent hospitalizations to quantify under-reporting of presentations.

Aims:

To quantify the proportion of emergency department (ED) presentations that could be identified as alcohol-related when linking to a patient's subsequent hospitalization, compared with using ED data alone, and to assess that comparison according to the change in alcohol harm rates over time and potential variations within subpopulations.

Design:

A retrospective study using linked hospital administrative data to identify ED patients who had subsequent alcohol-related hospitalizations.

Setting:

Western Australia.

Participants:

A total of 533 816 Western Australian young people (246 866 females and 286 950 males), aged 12-24 years.

Measurements:

Whether or not presentations of young people to ED could be identified as alcohol-related, and for those that were not, how many had a subsequent alcohol-related hospitalization. Rates and proportions of alcohol-related harm for both methods of ascertainment were estimated by sex and Aboriginality across different age groups.

Findings:

Alcohol-related hospitalizations that followed an initial presentation at ED allowed the identification of an additional 19 994 alcohol-related presentations (95% increase). Linking to additional hospitalization information also resulted in significant variation in alcohol-related harm trends. In particular, trends in alcohol-related ED presentations for 21-24-year-old males were stable to slightly increasing using only ED data, but decreased after linking with hospitalization data (P < 0.05). Similarly, trends among Aboriginal persons aged 21-24 shifted from increasing using only ED data to being stable in comparison to presentations using subsequent hospitalizations (P < 0.05).

Conclusions:

Among young people in Western Australia, twice as many emergency department presentations could be identified as being alcohol-related using diagnosis information from subsequent hospitalizations compared with emergency department data alone. When supplemented with hospitalization data, trends in alcohol-related harm presentations become significantly different within some subpopulations compared with using emergency department presentation data alone.

Keywords:

Alcohol-related harm data linkage emergency department hospitalizations trends young people

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