The intervention effect of local alcohol licensing policies on hospital admission and crime: a natural experiment using a novel Bayesian synthetic time-series method
The intervention effect of local alcohol licensing policies on hospital admission and crime: a natural experiment using a novel Bayesian synthetic time-series method
复制标题
DOI：
10.1136/jech-2017-208931
复制
发表时间：
2017-09-01
影响因子：
6.3
通讯作者：
Hickman, Matthew
中科院分区：
文献类型：
--
作者：
de Vocht, Frank;Tilling, Kate;Hickman, Matthew
背景在地方政府层面控制酒精许可是英格兰酒精政策的关键组成部分。然而，只有微弱的证据表明公共卫生有所改善。我们使用了一种新的自然实验设计，以估计新的地方酒精许可政策对住院率和criminal.Methods的影响，我们使用内政部许可数据（20072012年），以确定（1）干预措施：当地的累积影响区和增加许可证的执行，在2011年推出;和（2）控制：本地地区，既没有。结果是2009-2015年与酒精有关的住院，暴力和性犯罪以及反社会行为。贝叶斯结构时间序列被用来创建干预后合成时间序列（反事实）的基础上加权时间序列在控制领域。干预效果是根据测量趋势和预期趋势之间的差异计算的。验证分析进行了随机选择controls.Results 5干预和86个控制领域确定。干预与酒精相关的住院率平均下降6.3%（95%可信区间（CI）- 12.8%至0.2%）相关，并在较小程度上与暴力犯罪减少相关，特别是到2013年（-4.6%，95%CI- 10.7%至1.4%）。2013年（-8.4%，95%CI- 21.4%至4.6%）对性犯罪影响的证据不足，对反社会行为影响的证据不足，因为报告的变化。结论适度减少与酒精相关的住院和暴力及性犯罪与当地酒精许可政策的出台有关。这种新的方法有望用于公共卫生领域的其他自然实验。
Background Control of alcohol licensing at local government level is a key component of alcohol policy in England. There is, however, only weak evidence of any public health improvement. We used a novel natural experiment design to estimate the impact of new local alcohol licensing policies on hospital admissions and crime.Methods We used Home Office licensing data (20072012) to identify (1) interventions: local areas where both a cumulative impact zone and increased licensing enforcement were introduced in 2011; and (2) controls: local areas with neither. Outcomes were 2009-2015 alcohol-related hospital admissions, violent and sexual crimes, and antisocial behaviour. Bayesian structural time series were used to create postintervention synthetic time series (counterfactuals) based on weighted time series in control areas. Intervention effects were calculated from differences between measured and expected trends. Validation analyses were conducted using randomly selected controls.Results 5 intervention and 86 control areas were identified. Intervention was associated with an average reduction in alcohol-related hospital admissions of 6.3% (95% credible intervals (CI) - 12.8% to 0.2%) and to lesser extent with a reduced in violent crimes, especially up to 2013 (-4.6%, 95% CI - 10.7% to 1.4%). There was weak evidence of an effect on sexual crimes up 2013 (-8.4%, 95% CI - 21.4% to 4.6%) and insufficient evidence of an effect on antisocial behaviour as a result of a change in reporting.Conclusion Moderate reductions in alcohol-related hospital admissions and violent and sexual crimes were associated with introduction of local alcohol licensing policies. This novel methodology holds promise for use in other natural experiments in public health.