Detection of alcohol use disorders in general hospital admissions in the United States
Detection of alcohol use disorders in general hospital admissions in the United States
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DOI：
10.1001/archinte.164.7.749
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发表时间：
2004-04-12
影响因子：
--
通讯作者：
Ruhl, CE
中科院分区：
文献类型：
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作者：
Smothers, BA;Yahr, HT;Ruhl, CE
背景资料：先前的研究中，基于研究的评估酒精问题在入院时与医生的诊断进行了比较，表明许多住院患者的酒精诊断被遗漏。我们估计了在全国范围内，有研究为基础的酒精使用障碍诊断（“访谈阳性入院”）的住院样本中，医院记录记录酒精滥用或依赖以及其他酒精相关问题的检测程度。我们还估计了住院酒精干预和转介treatment.Methods：一个复杂的，多阶段的，概率样本的目的是代表nonmaternity，急性病入院非联邦，短期停留，综合医院在美国本土。该研究包括2040名住院患者，1613名男性和427名女性。当前（即过去12个月）精神疾病诊断和统计手册第四版酒精使用障碍的基于研究的诊断来自一个结构化的，计算机辅助的个人访谈，其中包含酒精使用障碍和相关残疾访谈时间表。通过回顾性分析封闭的医院记录，涵盖索引visit.Results：记录记录在案的诊断酒精相关的问题，发现在40%至42%的采访阳性入院的检测，住院治疗干预和治疗转诊的信息。住院干预率估计为21%的面试积极入院，治疗转诊率为24%。对于检测到的面试阳性的入院，估计率的干预和转介分别为50%和53%，respectively.Conclusions：估计率的检测，住院干预，并在入院治疗的酒精使用障碍的转诊率低。目前饮酒住院应筛选酒精问题作为入院常规的一部分，进一步的专业评估，干预和治疗转诊的指示。
Background: Previous studies in which research-based assessment for alcohol problems at admission was compared with physician diagnoses indicated that many alcohol diagnoses in hospitalized patients were missed. We estimated the extent to which hospital records documented detection of alcohol abuse or dependence and other alcohol-related problems in a national sample of hospital admissions having a research-based diagnosis of alcohol use disorder ("interview-positive admissions"). We also estimated rates of inpatient alcohol intervention and referral for treatment.Methods: A complex, multistage, probability sample was designed to represent nonmaternity, acute-care admissions to nonfederal, short-stay, general hospitals in the contiguous United States. The study included 2040 admissions, 1613 male and 427 female. Research-based diagnoses of current (ie, past 12 months) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol use disorder were derived from a structured, computer-assisted, personal interview containing the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Information on detection, inpatient intervention, and treatment referral were obtained via retrospective analysis of closed hospital records covering the index visit.Results: Record-documented diagnoses of alcohol-related problems were found in 40% to 42% of interview-positive admissions. Inpatient intervention rate was estimated at 21% for interview-positive admissions, and treatment referral rate, 24%. For detected interview-positive admissions, estimated rates of intervention and referral were 50% and 53%, respectively.Conclusions: Estimated rates of detection, inpatient intervention, and treatment referral of alcohol use disorders in hospital admissions were low. Current-drinking hospital admissions should be screened for alcohol problems as part of the admission routine, with further professional evaluation, intervention, and treatment referral as indicated.