Alcohol-related health services use and identification of patients in the emergency department

Study objective: To determine the relationship between alcohol-related emergency department visits and alcohol-related outpatient visits and the extent of identification and referral of these ED patients for alcohol treatment. Methods: A representative sample of ED patients in three medical centers of a large northern California health maintenance organization were interviewed and given breath alcohol rests, and their medical records were reviewed. An alcohol-related ED visit was defined as a visit meeting one or more of the following criteria: positive breath alcohol test result (.01 mg/dl or more), report of drinking in the 6 hours before the presenting injury or illness, ED visit for an alcohol-related problem, and a medical record notation of excessive alcohol use or an alcohol problem. Results: Among 988 ED patients, 91 were found to have an alcohol-related ED visit. Of the 91, 6 made an alcohol-related outpatient visit in the 12 months before the ED visit, and 10 made such a visit in the following 6 months. Among the 91 patients, 10 were identified as having an alcohol problem by the ED staff, and 1 was referred for alcohol treatment. Conclusion: The ED is an important point for the early identification and referral for treatment of alcohol-dependent and problem drinkers. The patient may make an alcohol-related ED visit relatively early in the pattern of alcohol-related health care use.