The detection of at‐risk drinking in a teaching hospital

A survey was carried out using the Canterbury Alcohol Screening Test (CAST) and clinical criteria for risk of alcohol withdrawal of 2000 randomly selected hospital in-patients in order to determine the prevalence of alcohol-related problems, the work-load for a specialist alcohol withdrawal service and the target group for early intervention. Patients at risk of alcohol withdrawal were followed prospectively.The major findings were: 14.3% of patients had a positive CAST and 8% were at risk of alcohol withdrawal; the prevalence of positive clinical criteria was greatest in men under the age of 30 years (OR 3.6) and very low (OR 0.34) in women over 60 years. In addition, patients who were too sick or refused to complete the questionnaire had high rates of being at risk for alcohol withdrawal. The prevalence of CAST positivity was greatest in men under the age of 40 years (OR 3.7) and lowest in women over 70 years (OR 0.2). It is concluded that 15-20% of in-patients have alcohol problems and 8% are at risk of withdrawal; questionnaires will produce underestimates of the order of 25%; and female in-patients over the age of 60 years are extremely unlikely to have problems with alcohol.

Section: Introductionmentioning

confidence: 99%

The incidence of alcohol‐related problems and the risk of alcohol withdrawal in a general hospital population

Foy

Kay

1995

“…This does not allow for the kinds of problems that are targeted in screening questionnaires such as AUDIT [18]. In addition, allocation of an ICD-9CM classification relies upon clinical diagnosis, with the attendant problem of underdiagnosis previously discussed [17]. The Version 3 DRGs for alcohol-related problems, having been derived from ICD-9CM, are thus likely to suffer from the same problems.…”

Section: Alcohol and Casemixmentioning

confidence: 99%

“…First, the ICD-9CM definitions underpinning the DRGs are orientated towards the more chronic and more dependent drinker and also towards those patients exhibiting the acute effects of alcohol intoxication, which will miss most of those for whom brief intervention is beneficial [2,4]. Secondly, the assignment of either of the two DRGs requires the diagnosis be made upon clinical examination by a doctor, which has been shown to miss the majority of those who are experiencing alcohol-related problems [17].…”

Section: Alcohol and Casemixmentioning

confidence: 99%

See 1 more Smart Citation

Alcohol, casemix and hospitals: an opportunity?

Ryder

1996

The number of patients in hospitals who experience alcohol-related problems is high, and the provision of intervention for these patients is a significant public health measure. The current move towards casemix funding of acute hospital services provides an opportunity for the development of such programmes. Modifications to the Diagnosis Related Groups categorization of alcohol-related problems that would allow for appropriate funding are discussed.

“…A study carried out in one of Sydney's teaching hospitals compared the information found in patients' medical files with that resulting from interviews with hospital patients. It found that only one-fifth of current or former at-risk drinkers had been identified by medical staff in the hospital and that "alcohol-related disease was rarely diagnosed, even when ample evidence was present to suspect such a diagnosis [5].…”

Section: • 246mentioning

confidence: 99%

The role of general practitioners in the delivery of drug and alcohol services to ethnic minority communities

Alcorso

1990

There has been increased emphasis on the need for early intervention in the treatment of drug and alcohol problems and on reducing consumption among 'low-risk' as well as among more heavily drug-dependent populations. At the same time, the doctor's role in recognising and treating drug and alcohol problems among their clients has been coming under closer scrutiny. An Illawarra-based study has examined these questions in the context of two non-English speaking background communities. Our findings are relevant not only to attempts to reconstruct the doctor-patient relationship, but to the question of health service provision in a multiethnic society generally.