Emergency care requirements in alcohol-related presentations: a multi-site observational study

Area of Science:

• Emergency Medicine
• Public Health
• Addiction Medicine

Background:

• Alcohol-related disorders impose substantial social and economic burdens globally.
• Emergency departments (EDs) frequently manage patients presenting with alcohol-related issues.
• Understanding the characteristics and costs of these presentations is crucial for resource allocation and intervention planning.

Purpose of the Study:

• To characterize alcohol-related presentations (ARPs) to emergency departments.
• To determine the clinical care requirements and outcomes for ARP patients.
• To quantify the resource utilization and costs associated with ARPs in Australian EDs.

Main Methods:

• A multi-site observational study was conducted in Queensland, Australia.
• A random sample of 2720 ARPs to four public hospital EDs between April 2016 and August 2017 was analyzed.
• Data included demographics, clinical care, outcomes, costs, and manual medical record review for detailed care delivery.

Main Results:

• ARPs predominantly involved young men, with 62% arriving by ambulance and 61% between 6 PM and 6 AM.
• Most patients received vital sign monitoring (83%), with significant proportions receiving pathology (46%), radiology (41%), medication (65%), or intravenous fluids (20%).
• The median ED length of stay was 194 minutes, the admission rate was 38%, and the median cost per ED episode was A$651.

Conclusions:

• Alcohol-related presentations represent a considerable drain on emergency department resources and finances.
• Effective public health strategies aimed at reducing alcohol-related harm could significantly decrease ED occupancy, workload, and associated costs.
• Targeted interventions within EDs and broader public health initiatives are warranted to mitigate the impact of alcohol on healthcare systems.