Alcohol consumption is the third leading cause of preventable death in the U.S., and health care costs related to alcohol consumption reached $24 billion in 2006. About $5.1 billion of those costs were due to alcohol-related hospitalizations.
In many cases, clinicians in hospital emergency departments are the gatekeepers who must make the difficult first decisions about how to care for patients in need of alcohol detoxification, including whether or not a patient should be admitted to the hospital or treated on an outpatient basis instead. Until recently there has been little clear clinical trial data available to help guide these decisions.
Now a new study by University of North Carolina School of Medicine researchers finds that an alcohol detoxification protocol they developed led to a statistically significant decrease in the number of admissions per month.
“Our main goal for the project was to standardize our hospitalist group’s care for a clinical problem we had found very challenging.”
“Our main goal for the project was to standardize our hospitalist group’s care for a clinical problem we had found very challenging. But as we implemented the change, we also studied the impact on number of admissions for these patients and found a meaningful decrease,” said John R. Stephens, MD, associate professor in the School of Medicine and lead author of the study, which was published online ahead of print by the Journal of General Internal Medicine.
The protocol is set forth in a 1-page flow chart that clinicians use to guide their decision-making process. After the protocol was implemented at UNC Hospitals, the average number of alcohol-related admissions per month dropped from 18.9 to 15.9. Each hospital admission for a primary alcohol-related diagnosis generates costs estimated at $8,742 per case, so a reduction of 3 admissions per month would generate cost savings of $315,000 per year, according to the study.
Co-authors of the study are E. Allen Liles, MD; Ria Dancel, MD; Michael Gilchrist, MD, MPH; Jonathan Kirsch, MD; and Darren A. DeWalt, MD, MPH. All are faculty in the Division of General Medicine and Clinical Epidemiology within the Department of Medicine.