Prevalence and Patterns of Hospital Use for People With Frequent Alcohol‐Related Hospital Admissions, Compared To Non‐Alcohol and Non‐Frequent Admissions: A Cohort Study Using Routine Administrative Hospital Data
Abstract
Aims
This study compared prevalence and hospital use among individuals frequently admitted to hospital in England with wholly attributable alcohol‐related diagnoses (WAAD), known as alcohol‐related frequent attenders (ARFAs), with those of non‐alcohol frequent attenders (NAFAs), non‐frequent alcohol attenders (ARNFAs) and non‐alcohol non‐frequent attenders (NANFAs).
Design
Cross‐sectional and longitudinal analyses of 5 years of England’s Hospital Episode Statistics (HES).
Setting
Hospital inpatients in England, UK, 2011–16.
Participants
Two cohorts (2011/12 = 489, 580/7 ,654, 944 patients and 2015/16 = 490 ,384/7 ,660 ,108 patients) were selected from all adult patients aged ≥ 18 years, treated in English hospitals between April 01, 2011 and March 31, 2016. Patients were categorized as having alcohol‐related admissions if diagnoses included a WAAD (ICD‐10 classification, WHO, 2016) and frequent admissions if they had more than three hospital admissions during a single HES year.
Measurements
Prevalence of ARFA, number of admissions (spells), occupied bed‐days (OBDs), average length of stay (ALOS) and total admission costs over 5 years were compared among ARFAs, ARNFAs, NAFAs and NANFAs.
Findings
On average, 0.7% of people admitted to hospital per annum in England 2011–15 were ARFAs and more than a quarter of all frequent attenders (for all causes) to hospitals had a wholly attributable alcohol diagnosis on admission. ARFAs had longer ALOS than the other patient groups [5.55 days versus ARNFA 4.7, NAFA 3.39 and NANFA 2.57 days, F = 1088.37 (3, 488 570, P < 0.001)] in the 2015/16 index year; but fewer spells than NAFAs [5.38 ARFAs versus 5.98 NAFAs, F = 20 536.25 (3, 490 380) P < 0.001]. The ARFA cohort reduced in size (from 51 934 ARFAs to 20 548) in the course of 5 years. ARFAs had the highest average total cost of admissions per person over 5 years at £38 189.
Conclusions
People with repeated admissions for alcohol‐related problems in England appear to be a high‐cost, high‐need, complex group of patients that makes up more than a quarter of the country’s alcohol admissions.
