From pubs to scrubs: Alcohol misuse and health care use

Ana I. Balsa, Michael T. French, Johanna Catherine MacLean, Edward C. Norton

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective. To analyze the relationships between alcohol misuse and two types of acute health care use - hospital admissions and emergency room (ER) episodes. Data Sources/Study Setting. The first (2001/2002) and second (2004/2005) waves of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC). Study Design. Longitudinal study using a group of adults (18-60 years in Wave 1, N=23,079). Gender-stratified regression analysis adjusted for a range of covariates associated with health care use. First-difference methods corrected for potential omitted variable bias. Data Collection. The target population of the NESARC was the civilian noninstitutionalized population aged 18 and older residing in the United States and the District of Columbia. The survey response rate was 81 percent in Wave 1 (N=43,093) and 65 percent in Wave 2 (N=34,653). Principal Findings. Frequent drinking to intoxication was positively associated with hospital admissions for both men and women and increased the likelihood of using ER services for women. Alcohol dependence and/or abuse was related to higher use of ER services for both genders and increased hospitalizations for men. Conclusions. These findings provide updated and nationally representative estimates of the relationships between alcohol misuse and health care use, and they underscore the potential implications of alcohol misuse on health care expenditures.

Original languageEnglish (US)
Pages (from-to)1480-1503
Number of pages24
JournalHealth Services Research
Issue number5 PART 1
StatePublished - Oct 2009


  • Alcohol misuse
  • First-difference estimation
  • Health care use
  • Problem drinking

ASJC Scopus subject areas

  • Health Policy


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