Alcohol Intoxication in the Academic Emergency Department: Epidemiology and Facility-Fee Financial Impact

Area of Science:

• Emergency Medicine
• Healthcare Finance
• Public Health

Background:

• Alcohol intoxication is a frequent reason for emergency department (ED) visits in urban settings.
• Limited data exists on the financial implications of treating alcohol-intoxicated patients in the ED.
• This study investigates the financial impact of ED visits for acute alcohol intoxication.

Purpose of the Study:

• To analyze facility billings and collections for patients presenting to the ED with alcohol intoxication.
• To quantify the financial burden and resource utilization associated with these visits.

Main Methods:

• Retrospective cohort analysis of ED visits between June 2018 and December 2021 across two large urban EDs.
• Inclusion criteria: discharge diagnosis of acute alcohol intoxication with minimal or no interventions.
• Analysis of facility charges, insurance status, and average payments.

Main Results:

• 13,454 patients (2.7% of total visits) met study criteria.
• Alcohol intoxication visits accounted for an average of 43.2 ED bed hours per day.
• Total facility charges were $22,590,000, with an estimated reimbursement of $1.7 million (7.5%).

Conclusions:

• Patients with acute alcohol intoxication represent a small but resource-intensive patient group in the ED.
• The estimated collection rate for these visits is only 7.5%, highlighting significant unreimbursed costs.
• Cost-effectiveness of alcohol-related interventions should account for the substantial financial burden of these ED visits.