Estimating the Burden of Alcohol on Ambulance Callouts through Development and Validation of an Algorithm Using Electronic Patient Records
Abstract
Background
Alcohol consumption places a significant burden on emergency services, including ambulance services, which often represent patients’ first, and sometimes only, contact with health services. This study aimed to (1) improve the assessment of this burden on ambulance services in Scotland using a low-cost and easy to implement algorithm to screen free-text in electronic patient record forms (ePRFs), and (2) present estimates on the burden of alcohol on ambulance callouts in Scotland.
Methods
Two paramedics manually reviewed 5416 ePRFs to make a professional judgement of whether they were alcohol-related, establishing a gold standard for assessing the algorithm performance. They also extracted all words or phrases relating to alcohol. An automatic algorithm to identify alcohol-related callouts using free-text in EPRs was developed using these extracts.
Results
The algorithm had a specificity of 0.941 and a sensitivity of 0.996 in detecting alcohol-related callouts. Applying the algorithm to all callout records in Scotland in 2019, the study identified 86,780 (16.2%) as alcohol-related. At weekends, this percentage was 18.5%.
Conclusions
Alcohol-related callouts constitute a significant burden on the Scottish Ambulance Service. The algorithm of this study is significantly more sensitive than previous methods used to identify alcohol-related ambulance callouts. This approach and the resulting data have potential for the evaluation of alcohol policy interventions as well as for conducting wider epidemiological research.
