Hazardous drinkers and drug users in HMO primary care: Prevalence, medical conditions, and costs
Hazardous drinkers and drug users in HMO primary care: Prevalence, medical conditions, and costs
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DOI：
10.1097/01.alc.0000167958.68586.3d
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发表时间：
2005-06-01
影响因子：
3.2
通讯作者：
Walsh, K
中科院分区：
文献类型：
--
作者：
Mertens, JR;Weisner, C;Walsh, K
背景：有大量证据表明，有酒精和药物障碍的人会增加合并症和医疗费用。然而，对于更多的“危险”饮酒者(那些饮酒者的消费增加了他们“身体和心理伤害的风险”)和吸毒者的情况，人们知之甚少。方法：对来自HMO初级保健诊所的1419名患者进行了危险饮酒和药物使用的筛查。健康计划数据库用于检查危险饮酒者和吸毒者在筛查前一年的医疗状况和医疗费用，与来自同一诊所的13,347名患者进行比较。结果：我们发现危险饮酒和初级保健中使用药物的患病率分别为7.5%和3.2%(10%至少有这两个问题中的一个)。危险的饮酒者和吸毒者增加了八种医疗疾病的患病率，包括伤害和高血压等代价高昂的疾病以及精神疾病。除有精神疾病者外，调查年度的医疗费用并不较高。结论：危险饮酒和药物使用的患病率与高血压和糖尿病相似。危险饮酒者和吸毒者日益严重的医疗状况，特别是与酗酒和吸毒有关的疾病，表明在危险饮酒和吸毒这一较低门槛的筛查和短暂干预将更快地发现有健康风险的个人。某些医疗疾病的最佳治疗和预防可能需要对潜在的危险酒精或药物使用进行识别和干预。
Background: There exists substantial evidence that individuals with alcohol and drug disorders have heightened comorbidities and health care costs. However, little is known about the larger population of "hazardous" drinkers (those whose consumption increases their "risk of physical and psychological harm") and drug users.Methods: A sample of 1,419 patients from HMO primary care clinics was screened for hazardous drinking and drug use. Health plan databases were used to examine medical conditions and health care costs of hazardous drinkers and drug users in the year prior to screening, in comparison to 13,347 patients from the same clinics, excluding those screened.Results: We found a prevalence of 7.5% for hazardous drinking and 3.2% for drug use in primary care (10% had at least one of the two problems). Hazardous drinkers and drug users had heightened prevalences for eight medical conditions, including costly conditions such as injury and hypertension, and psychiatric conditions. Medical costs for the year examined were not higher, except for those who also had psychiatric conditions.Conclusions: The prevalence of hazardous drinking and drug use was similar to hypertension and diabetes. Hazardous drinkers and drug users' heightened medical conditions, especially those related to alcohol and drug abuse, indicate that screening and brief intervention at this lower threshold of hazardous drinking and drug use will detect individuals with health risks sooner. Optimal treatment and prevention of some medical disorders may require identification and intervention of underlying hazardous alcohol or drug use.