2026-04-17T06:21:32Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/2243652025-12-05T01:56:42Zcom_2072_1057col_2072_478917col_2072_478921

00925njm 22002777a 4500 dc Gual, Antoni author López Pelayo, Hugo author Balcells Oliveró, Maria Mercè author Oliveras, Clara author Bruguera Soler, Pol author Cordero Torres, Imanol author Millán Hernández, Andrea author Pons-Cabrera, Maria Teresa author Guzmán Cortez, Pablo Rodrigo author Gómez-Ramiro, Marta author Vázquez, Mireia author Borràs, Roger author Asenjo Romero, Maria author Vieta i Pascual, Eduard, 1963- author 2025-11-13T19:04:24Z 2025-11-13T19:04:24Z 2024-12-03 2025-11-13T19:04:24Z Introduction: Alcohol-related problems increase the probability of frequent emergency department (ED) use. In this study, we compared the direct healthcare expenses incurred during a single visit among frequent and non-frequent ED users and analyzed the impact of alcohol-related issues in healthcare costs arising from ED usage. Methods: The study relied on secondary analyses of economic data from a 1:1 matched case-control study with the primary aim of identifying the clinical characteristics of hospital ED frequent users in a Mediterranean European environment with a public, universal, and tax-funded health system. The participants ranged in age from 18 to 65 years and underwent ED visits at a high-complexity Spanish hospital (cases ≥5 times, controls <5) from December 2018 to November 2019. Each case was matched to a control with the same age, gender, and date of attendance at the ED. Clinical data and direct healthcare costs for a single ED visit were obtained by a retrospective review of the first electronic medical register. Costs and duration of stay were compared between cases and controls using paired-samples t-tests, and ED users with and without alcohol-related problems were compared using bivariate (independent-samples t-tests, one-way analysis of variance, Chi square tests, and multiple linear regression) and multivariate analyses (multiple linear regression models with backward stepwise selection algorithm, and dependent variable: total mean direct costs). Results: Among 609 case-control pairs (total n = 1218), mean total healthcare direct costs per ED visit were 22.2% higher among frequent compared with non-frequent users [mean difference 44.44 euros; 95% confidence interval (CI) 13.4-75.5; t(608) = 2.811; p = 0.005]. Multiple linear regression identified length of stay, triage level, ambulance arrival, and the specialty discharging the patient as associated with total healthcare costs for frequent users. In bivariate analyses, a history of alcohol-related problems was associated with a 32.5% higher mean total healthcare costs among frequent users [mean difference 72.61 euros; 95% confidence interval 25.24-119.97; t(320.016) = 3.015; p = 0.003]. Conclusion: The findings confirm the high cost of frequent ED use among people with alcohol-related problems, suggesting that costs could be reduced through implementation of intervention protocols. Alcohol Serveis d'urgències mèdiques Psiquiatria Alcohol Emergency medical services Psychiatry Effects of alcohol-related problems on the costs of frequent emergency department use: an economic analysis of a case–control study in Spain