Alcohol use among HMO patients in the emergency room, primary care and the general population

Although heavy drinking and alcohol-related problems are overpresented among patients seen in some primary care settings compared to the general population, it is not known whether those seen for noninjury problems in emergency rooms (ERs) are similar in demographic and drinking characteristics to those seen in primary care clinics. Nor do we know whether alcohol-related problems are over-represented in both of these settings compared to the general population when equal access to health care services is provided, as by membership in the same HMO. Reported here are data from a single northern California health maintenance organization (HMO).

Probability samples of noninjured patients seen in the ERs of the HMO (n = 579) are compared on demographic characteristics and drinking patterns and problems to those seen in the primary care clinics of the same HMO (n = 295) and to those in the general population of the same county who reported membership in the HMO (n = 737).

No differences in drinking patterns, alcohol-related problems or gender or age distribution were found between the clinic patients and the noninjured ER patients. Both the noninjured ER patients and the clinic patients were less likely to report heavy and problem drinking, or treatment for an alcohol-related problem during the last year, as compared to those in the general population.

The data from this HMO study suggest that noninjured patients seen in these particular emergency rooms resemble those seen in primary care, and that, contrary to the commonly held belief that alcohol-related problems are overrepresented in primary care, primary care patients in this HMO population may be less likely to be problem drinkers than those in the general population from which they come.