Almost three quarters of weekend emergency care caseload is linked to excess alcohol intake, according to an analysis of one large inner-city hospital in England.
Each case costs between £250 ($274 U.S.) and £850 ($929 U.S.) to treat, or £1 million ($1.09 million) every year, according to the analysis, which was published in Emergency Medicine Journal.
For the analysis, researchers reviewed the case notes of patients requiring treatment associated with excess alcohol at one large inner city emergency department in the northeast of England, over a period of four separate weeks in February-March, July, October, and December during 2010-11. They also tracked additional episodes of related care over the subsequent 12 months.
The team carried out breath testing of emergency room patients during the same four weeks in 2012-13 to find out who had been drinking.
Some 12 percent (636) of the 5,121 patients over the four weeks of 2010-11 were linked to alcohol. In 2012-13, this had risen to 15 percent (720 out of 6,526 attendances).
In 2012-13, the alcohol-related attendance rate during the specified four weeks varied substantially from four percent to 60 percent on week days, but rose to 70 percent during the weekends, the analysis found.
Attendance patterns were similar over both timeframes, with young men between the ages of 18 and 24 showing up in the early hours of the morning, making up the bulk of the weekend caseload. Traumatic injuries and mental health issues were the most common reasons for seeking care, the researchers reported.
Some 498 people tested positive for alcohol on the breath test. The analysis found people who didn’t live in the city were significantly more likely to test positive than local residents, suggesting that city hospitals attract revellers from elsewhere, while hospitals and other public services in city centers pick up the tab, according to the researchers.
They calculated the costs of treating alcohol related cases, based on the tests, procedures, outpatient appointments, and inpatient stays detailed in the patients’ hospital records.
These ranged from an average of £250 up to £850, if admission to hospital was required. That adds up to an annual bill of £1 million, without including ambulance service and police costs.
“This indicates a significant National Health Service (NHS) burden if all such emergency departments in the UK are sustaining similar demands associated with alcohol related attendance,” the researchers said in the study. “Although older people may cost more per patient, younger people as a group are more costly to the NHS because they have more alcohol related attendances.”
“Our results suggest that emergency departments would benefit from routinely providing staff to cover the night and early morning shifts, particularly at weekends, to cope with the high proportion of alcohol-related attendances at these times,” they conclude.
In a linked editorial, Dr. Clifford Mann, emergency care consultant at Taunton and Somerset NHS Foundation Trust, points out that in England alone, one million hospital visits every year are related to alcohol, at a cost to the NHS of £3.5 million. Hospital admissions for disease and injuries associated with alcohol rose 100 percent between 2003 and 2013.
“Current national and international data describing the financial burden of alcohol are dramatic, yet the response of governments has been woefully inadequate,” he said.
Alcohol is too cheap and too readily available, he noted, reiterating the call made by the Royal College of Emergency Medicine and many other medical organizations for a minimum unit pricing for alcohol of £0.50.
“Currently it is perfectly feasible to purchase a volume of alcohol that represents a safe weekly maximum for less than £10. Alcohol at this price is cheaper than bottled water,” he said. “The economic, social, and medical consequences of current alcohol strategies create a compelling argument for improved legislation and regulation of alcohol sales.”
Public Health England estimates that the total annual cost to society of alcohol is £21 billion, which compares with the total cost of £2 billion for running every A&E in the UK, he points out.