Modeling the Impact of COVID-19 Pandemic-Driven Increases in Alcohol Consumption on Health Outcomes and Hospitalization Costs in the United States
Abstract
Background and aims
Alcohol consumption increased in the early phases of the COVID-19 pandemic in the United States. Alcohol use disorder (AUD) and risky alcohol use are linked to harmful health effects. This paper aimed to project future health and cost impacts of shifts in alcohol consumption during the COVID-19 pandemic.
Design
An individual-level simulation model of the long-term alcohol use patterns for people with lifetime AUD was used to simulate 10,000 individuals and project model outcomes to the estimated 25.9 million current alcohol users with lifetime AUD in the United States. The model considered three scenarios: (1) No Change (counterfactual for comparison); (2) increased alcohol use levels persist for 1 year (“Increase-1”), and (3) increased alcohol use levels persist for 5 years (“Increase-5”).
Setting
United States.
Participants
Current alcohol users with lifetime AUD.
Measurements
Life expectancy (or life-years [LYs]), quality-adjusted life-years (QALYs), alcohol-related hospitalizations and associated hospitalization costs, and alcohol-related deaths, over a 5-year horizon.
Findings
Short-term increases in alcohol consumption (Increase-1 scenario) resulted in a loss of 79,000 (95% Uncertainty Interval [UI] 26,000–201,000) LYs, a loss of 332,000 (104,000–604,000) QALYs, and 295,000 (82,000–501,000) more alcohol-related hospitalizations, costing an additional $5.4 billion ($1.5 billion–$9.3 billion), over 5 years. Hospitalizations for cirrhosis of the liver accounted for about $3.0 billion ($0.9 billion–$4.8 billion) in hospitalization costs, more than half of the increase across all alcohol-related conditions. Health and cost impacts were more pronounced for older age groups (51+), women, and non-Hispanic Black individuals. Increasing the duration of pandemic-driven increases in alcohol consumption in the Increase-5 scenario resulted in larger impacts.
Conclusions
Simulations show that if the increase in alcohol consumption observed in the United States in the first year of the pandemic continues, alcohol-related mortality, morbidity, and associated costs will increase substantially over the next 5 years.
