Emergency room and primary care services utilization and associated alcohol and drug use in the United States general population

Heavy and problem drinking have been found to be over-represented in some studies of clinical populations, but little is known of the association of alcohol and drug use with health services utilization in the general population. General population data are reported on the association of alcohol, drug use, and demographic characteristics with use of the Emergency Room (ER) or other primary care services during the preceding year. Data analysed are from the 1995 National Alcohol Survey of respondents living in households in the 48 contiguous states. Logistic regression was used to analyse the association of substance-use variables with ER and primary care services use by gender within three ethnic groups: white (n = 1636), black (n = 1582) and Hispanic (n = 1585). Variables found to be associated with ER use were not associated with primary care services use and vice versa. Drinking and drug-use characteristics appeared to be more associated with ER use than with primary care use, and varied across ethnic and gender subgroups. The data suggest an association between treatment for alcohol or drug problems and services use, particularly among blacks and Hispanics. The data support findings from clinical studies that overrepresentation of substance-use problems in some clinical settings may be due to the socio-demographic characteristics of those using the facility under study, and suggest that ER and other primary care service settings may be useful for identifying those with alcohol and drug-regulated problems among specific gender/ethnic groups.