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

Effects of alcohol-related problems on the costs of frequent emergency department use: an economic analysis of a case–control study in Spain Gual, Antoni López Pelayo, Hugo Balcells Oliveró, Maria Mercè Oliveras, Clara Bruguera Soler, Pol Cordero Torres, Imanol Millán Hernández, Andrea Pons-Cabrera, Maria Teresa Guzmán Cortez, Pablo Rodrigo Gómez-Ramiro, Marta Vázquez, Mireia Borràs, Roger Asenjo Romero, Maria Vieta i Pascual, Eduard, 1963- Alcohol Serveis d'urgències mèdiques Psiquiatria Alcohol Emergency medical services Psychiatry 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. 2025-11-13T19:04:24Z 2025-11-13T19:04:24Z 2024-12-03 2025-11-13T19:04:24Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.3389/fpubh.2024.1322327 Frontiers In Public Health, 2024, vol. 12 https://doi.org/10.3389/fpubh.2024.1322327 cc-by (c) Oliveras, C. et al., 2024 http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Frontiers Media Articles publicats en revistes (Medicina)