Association Between Alcohol Brief Intervention and Emergency Department and Inpatient Utilization Over 2 Years

Area of Science:

• Health Services Research
• Public Health
• Substance Use Disorders

Background:

• Brief Interventions (BIs) are effective for unhealthy alcohol use but their impact on acute healthcare utilization is unclear.
• Primary care settings are crucial for delivering BIs to a broad population.
• Understanding the long-term effects of BIs on healthcare services is essential for resource allocation.

Purpose of the Study:

• To examine the association between receiving a BI in primary care and subsequent Emergency Department (ED) and inpatient utilization.
• To assess the impact of BIs over a 2-year follow-up period in adults screening positive for unhealthy alcohol use.
• To provide evidence for the effectiveness of BIs in reducing acute healthcare services.

Main Methods:

• Retrospective, population-based observational study using electronic health record (EHR) data.
• Included 254,190 adult primary care patients who screened positive for unhealthy alcohol use.
• Generalized estimating equation (GEE) logistic models with inverse probability treatment weighting (IPTW) were used to analyze BI receipt and healthcare utilization over 24 months.

Main Results:

• Receiving a BI was associated with significantly lower odds of ED utilization (aOR: 0.96) and inpatient utilization (aOR: 0.96) over 2 years.
• The association between BI and ED utilization decreased over time.
• BI was significantly associated with lower inpatient utilization only within the first 6 months post-intervention.

Conclusions:

• BI programs in primary care are linked to reductions in acute healthcare utilization.
• The harm-reduction effects of BIs on healthcare services have a measurable duration.
• Findings support the broad implementation of BIs in primary care to reduce acute healthcare demand.